Principios de Neurociencia: Aplicaciones básicas y clínicas (Spanish Edition)

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The first book for the general public about the importance of mindfulness Today we are experiencing extraordinary technological advances in the diagnosis and treatment of illness while Risk factors for newonset overactive bladder in older subjects: Results of the Fujiwara-kyo study. Neurourol Urodyn. Resultados da Amostra [Internet]. Translating overactive bladder questionnaires in 14 languages.

Reliability of the Brazilian version of the geriatric depression scale GDS short form. Anxiety disorders in older adults: a comprehensive review. Depress Anxiety. Fisioter Pesqui. Risk factors for overactive bladder in the elderly population: a community-based study with face-to-face interview.

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Int J Urol. Urology [Internet]. Urinary incontinence in older women: who is at risk? Study of Osteoporotic Fractures Research Group. Obstet Gynecol [Internet]. Relationship between anxiety and overactive bladder syndrome in older women. Rev Bras Ginecol Obstet [Internet]. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with Interstim therapy compared to standard medical therapy at 6 monts in subjects with mild symptoms of overactive bladder.

Prevalence of overactive bladder, its underdiagnosis, and risk factors in a male urologic veterans population. Int J Med Sci. Ekundayo OJ. The association between overactive bladder and diuretic use in the elderly. Curr Urol Rep. Acta Cir Bras. Cuid Enferm. Comparisons of pelvic floor muscle performance, anxiety, quality of life and life stress in women with dry overactive bladder compared with asymptomatic women.

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Abraham N, Vasavada S. Urgency After a Sling: Review of the Management [abstract]. Curr Urol Rep [Internet]. Obstet Gynecol Surv. J Sex Med [Internet]. Urinary disorders and female sexual function. Bowling A. Mode of questionnaire administration can have serious effects on data quality. J Public Health. Influence of a protocol of Pilates exercises on the contractility of the pelvic floor muscles of non-institutionalized elderly persons. Abstract Objective: To investigate the influence of a protocol of Pilates exercises on the functionality and contractility of the pelvic floor muscles PFM of older women living in the city of Campo Grande, Mato Grosso, Brazil.

Method: Ten women median age of Results: In view of the proposed treatment, the degree of voluntary contraction of the PFM of the participants increased from Conclusion: The results indicate that the Pilates method increased the contractility and pressure of the PFM of elderly women with little or no PFM impairment. Further studies are required to determine whether the Pilates method is an effective method for the treatment of women with severe pelvic floor dysfunction. Introduction Pilates emerged as a method of rehabilitation during World War I, when Joseph Hubertus Pilates applied his knowledge to rehabilitate injured men.

The popularity of the method grew most in the s1,2. More recently, Pilates has been used by health care professionals to integrate the mind and body of subjects, resulting in improved fitness flexibility, strength and balance and body consciousness. The method features ground and apparatus-based exercises created by Joseph Pilates There are six key principles involved in Pilates: concentration, control, precision, f luidity of movement, breathing and center of strength1,3,5.

The center of strength, also called the "core", "power house" or "engagement" refers to the region of specific groups of muscles anterior abdominal wall, spinal extensors, hip extensors, hip flexors and pelvic floor muscles. The pelvic floor PF consists of muscles, fascia and ligaments that occupy the region of the lower pelvis. These muscles are classified as skeletal striated or voluntary contraction muscles, and thus respond to training techniques just like the other skeletal muscles of the human body.

There are two hypotheses about the mechanisms by which the strengthening of this muscle group can prevent or treat urinary incontinence and pelvic organ prolapse. These are: 1 women develop the ability to consciously contract the pelvic floor muscles before and during the increase of intraabdominal pressure; and 2 the strengthening of this muscle group can build support for the bladder and uretra6.

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Due to the fact that most Pilates exercises are performed in conjunction with the recruitment of PF muscle fibers, many Pilates instructors believe that the method can produce a significant increase in the force or contractility of the muscles. Furthermore, if Pilates promotes an improvement in the functioning of the pelvic floor muscles PFM , it may be an alternative for the treatment and prevention of pelvic floor dysfunction.

Urinary incontinence, pelvic organ prolapse and other manifestations of pelvic floor dysfunction are. These symptoms are associated with a number of factors that lead to damage to the integrity of the pudendal nerve or skeletal muscle fibers of the levator ani or coccygeus muscles8. Due to the high prevalence of pelvic floor dysfunction among the elderly, the present study aimed to verify the influence of a protocol of Pilates exercises on the functionality and contractility of the PFM of elderly women. The subjects were invited to participate in the survey via telephone.

However, eleven did not meet the inclusion criteria, six declined the invitation and three alleged personal reasons that prevented them from attending the exercise therapy sessions. The present study therefore adopted a longitudinal design, in which ten elderly women were accompanied during the execution of the procedure. Due to the lack of studies addressing the impact of Pilates on the PFM, it was not possible to use data published in literature to calculate the effect size. Thus, the delimitation of this topic was carried out using the hypothesis of improvement initially stipulated by the authors.

From the calculations, the ideal sample size should be at least 28 subjects.

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  8. This fact led us to an initial screening of 30 subjects, as shown in Figure 1. The women were aged over 60 years, sexually active, non-smokers, non-alcoholics, with no clinical diagnosis of pelvic floor dysfunction, no history. Women who were allergic to latex gloves or condoms. Based on these criteria, the initial sample suffered considerable losses and included ten participants, as detailed in figure 1. The participants were previously informed about the data collection procedures, and all signed a free and informed consent form.

    Assessments and reassessments were performed by the same researcher. Anamnesis was performed initially, and soon after the pressure and contractility of the PFM were assessed, performed with the patient in the dorsal lithotomy position8. Perineometry is a pressure gauge which captures the pressure generated during the activation of the PFM, providing a reading on the display of the device on a scale in cmH2O. The equipment has an attached latex vaginal probe 25X90 cm inflated by a pear type control9. The "R" repetitions result assesses the number of repetitions of the sustained contraction up to 10 that the participant is able to perform with satisfactory duration 5 seconds , with 4 seconds between each contraction.

    During the vaginal probe measurements the probe is coated a non-lubricated condom and inserted into the vaginal canal of the participant to capture the contractions. After the observing and recording of the intensity in cmH2O of five maximal voluntary contractions, with a 5 second interval between each, the average was calculated.

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    Perineal contractions were held during expiration,. There was a rest interval of two minutes between perineometry assessment and the evaluation of vaginal palpation. The participants were instructed to contract the PFM following the commands given by the examiner, which followed the steps determined by the PERFECT scheme and the intervals of rest All evaluations were performed before and after the week follow-up period. Chart 1 demonstrates the Pilates protocol realized in the present study. It was performed twice a week, with each session lasting 60 minutes, for 12 weeks, totaling 24 sessions.

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    The progression of the exercises was based on increasing the number of repetitions of the exercise, and variations in posture from beginner to intermediate and advanced, for each exercise. The movements were repeated six to eight times each. Statistical analysis of the data was performed through descriptive and inferential analysis. The Wilcoxon paired test was used for inferential analysis, while still respecting the nonparametric sum of the data.

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    Ethical approval was previously obtained from the institutional review board, and the research was registered under number Chart 1. Exercise protocol applied to the subjects. Breathe slowly and concentrate on diaphragm movement. As air is exhaled, with pursed lips, perform isometrics in the "power house".

    Prone, pelvis and spine neutral. Legs straight and lateral rotation. Bent arms next to the torso. Inhale and stretch arms and raise the trunk. Lying supine, legs bent and feet parallel. The movement is initiated by the activation of the power house, followed by gluteal contraction, retroversion of the pelvis and lifting of the pelvis.

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    The return is targeted to the starting position. Lying supine, knees bent, feet flat on the floor, arms at sides. Inhale and raise the head and trunk until reaching the base of the shoulder blades. Inhale for 5 pulses and perform the cycle to complete pulsations. Lying supine, supported trunk, hips and knees bent, raise the cervical spine, hold the ankles with the hands.

    Extend legs and arms simultaneously to 45 degrees and back to the starting position, without letting the feet touch the ground. Standing, neutral pelvis, heels together, raise the body, resting the hands on a bar, bend the knees and hips with hip external rotation, power house drive.

    Return to starting position. Supine, both arms extended above the head and with the knees bent. Participants must move from lying to sitting, arms extending toward the feet, flexing the trunk and holding the arms outstretched.