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A incontinência urinária (IU) feminina constitui um problema de saúde pública com impacto significativo na qualidade de vida das mulheres, mantendo-se frequentemente subdiagnosticada e subtratada. Em Portugal, a fisioterapia pélvica tem vindo a afirmar-se como abordagem conservadora relevante, embora ainda enfrente desafios na sua plena integração nos cuidados de saúde. O presente estudo teve como objetivo caracterizar a atuação dos fisioterapeutas na abordagem da IU feminina em Portugal, analisando práticas clínicas, estratégias terapêuticas, instrumentos de avaliação e perceções dos profissionais relativamente aos principais desafios da intervenção nesta área. Foi aplicado um questionário online a fisioterapeutas em exercício profissional, obtendo-se 119 respostas válidas. Os resultados evidenciam uma prática clínica globalmente alinhada com as recomendações internacionais, com destaque para a utilização do treino dos músculos do pavimento pélvico e de abordagens terapêuticas combinadas e individualizadas. Os instrumentos de avaliação mais frequentemente referidos foram o exame físico por palpação vaginal, o diário miccional e questionários padronizados. A análise qualitativa permitiu identificar desafios que ultrapassam a dimensão técnica, nomeadamente a adesão limitada das utentes ao tratamento, a fraca literacia em saúde e a necessidade de maior articulação interprofissional, fatores que influenciam o acesso e a continuidade dos cuidados. Conclui-se que este estudo contribui para uma melhor compreensão da prática clínica em fisioterapia pélvica no contexto nacional, evidenciando a importância de reforçar estratégias de educação em saúde, sensibilização interprofissional e investigação futura, de modo a promover cuidados mais acessíveis, informados e centrados na mulher com IU.
ABSTRACT Female urinary incontinence (UI) is a public health problem with a significant impact on women’s quality of life and remains frequently underdiagnosed and undertreated. In Portugal, pelvic health physiotherapy has been increasingly recognized as a relevant conservative approach, although challenges persist regarding its full integration into healthcare services. This study aimed to characterize the role of physiotherapists in the management of female UI in Portugal by analysing clinical practices, therapeutic strategies, assessment instruments, and professionals’ perceptions of the main challenges associated with intervention in this area. An online questionnaire was administered to practising physiotherapists, yielding 119 valid responses. The results indicate a clinical practice generally aligned with international recommendations, with particular emphasis on pelvic floor muscle training and the use of combined and individualized therapeutic approaches. The most frequently reported assessment tools were vaginal digital palpation, bladder diaries, and standardized questionnaires. Qualitative analysis identified challenges extending beyond the technical domain, namely, limited patient adherence to treatment, low health literacy, and the need for stronger interprofessional collaboration, all of which influence access to and continuity of care. This study contributes to a better understanding of clinical practice in pelvic health physiotherapy within the national context, highlighting the importance of strengthening health education strategies, interprofessional awareness, and future research to promote more accessible, informed, and woman-centred care for individuals with UI.
ABSTRACT Female urinary incontinence (UI) is a public health problem with a significant impact on women’s quality of life and remains frequently underdiagnosed and undertreated. In Portugal, pelvic health physiotherapy has been increasingly recognized as a relevant conservative approach, although challenges persist regarding its full integration into healthcare services. This study aimed to characterize the role of physiotherapists in the management of female UI in Portugal by analysing clinical practices, therapeutic strategies, assessment instruments, and professionals’ perceptions of the main challenges associated with intervention in this area. An online questionnaire was administered to practising physiotherapists, yielding 119 valid responses. The results indicate a clinical practice generally aligned with international recommendations, with particular emphasis on pelvic floor muscle training and the use of combined and individualized therapeutic approaches. The most frequently reported assessment tools were vaginal digital palpation, bladder diaries, and standardized questionnaires. Qualitative analysis identified challenges extending beyond the technical domain, namely, limited patient adherence to treatment, low health literacy, and the need for stronger interprofessional collaboration, all of which influence access to and continuity of care. This study contributes to a better understanding of clinical practice in pelvic health physiotherapy within the national context, highlighting the importance of strengthening health education strategies, interprofessional awareness, and future research to promote more accessible, informed, and woman-centred care for individuals with UI.
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Fisioterapia Fisioterapia pélvica Saúde da mulher Incontinência urinária Physiotherapy Pelvic physiotherapy Women's health Urinary incontinence MFT