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Authors
Advisor(s)
Abstract(s)
Introdução: As alterações que ocorrem durante a gravidez têm influência na estrutura e função do pavimento pélvico (PP). Por sua vez, o parto vaginal está diretamente relacionado com o aparecimento de disfunções do pavimento pélvico (DPP) a longo prazo. A compressão e o estiramento que as estruturas sofrem no parto provocam alterações na ativação muscular do PP. As patologias uroginecológicas representam uma consequência direta do parto vaginal, com maior prevalência aquando laceração ou episiotomia uma vez que alteram a função do PP. A Eletromiografia (EMG) é uma ferramenta utilizada por Fisioterapeutas que avalia a ativação muscular o PP. Objetivo: verificar se existe relação entre as lacerações perineais resultantes do parto e a atividade muscular do pavimento pélvico. Metodologia: Trata-se de uma metodologia caso-controlo em que se pretende comparar a ativação muscular do pavimento pélvico, através de EMG entre mulheres nulíparas e mulheres primíparas, durante o repouso e durante a contração voluntária máxima (CVM). Resultados: A ativação muscular do PP, medida por EMG, é superior nas nulíparas, tanto na CVM como no repouso. No entanto estas diferenças só são estatisticamente significativas durante o repouso. Conclusão: Tendo em conta o número reduzido de participantes, não é possível confirmar se as lacerações têm um impacto negativo na ativação muscular do PP das primíparas.
ABSTRACT - Introduction: The modifications that occur during pregnancy influence the structure and function of the pelvic floor (PF). Nevertheless, vaginal birth is directly related to the appearance of long-term Pelvic Floor Dysfunctions (PFD). The compression and strain that the structures suffer during childbirth cause changes in the PF’s muscle activation. Urogynecological pathologies represent a direct consequence of vaginal birth and have a higher prevalence when lacerations occur or episiotomy is performed, as they modify the function of the PF. Electromyography (EMG) is a tool used by physiotherapists in the evaluation of pelvic floor muscular activity. Objective: To establish a connection between the perineal lacerations resulting from childbirth and muscle activity of the pelvic floor. Methodology: It is a case-control study in which we compare nullipara and primipara women pelvic floor muscle activity via EMG, during its resting period, and during its maximum voluntary contraction. Results: The PP muscle activation, measured by EMG, is superior in nulliparous women, both in CVM as at rest. However, these differences are only statistically significant during rest. Conclusion: Due to the small number of participants, it is not possible to confirm that the lacerations have a negative impact on muscular activation of the pelvic floor.
ABSTRACT - Introduction: The modifications that occur during pregnancy influence the structure and function of the pelvic floor (PF). Nevertheless, vaginal birth is directly related to the appearance of long-term Pelvic Floor Dysfunctions (PFD). The compression and strain that the structures suffer during childbirth cause changes in the PF’s muscle activation. Urogynecological pathologies represent a direct consequence of vaginal birth and have a higher prevalence when lacerations occur or episiotomy is performed, as they modify the function of the PF. Electromyography (EMG) is a tool used by physiotherapists in the evaluation of pelvic floor muscular activity. Objective: To establish a connection between the perineal lacerations resulting from childbirth and muscle activity of the pelvic floor. Methodology: It is a case-control study in which we compare nullipara and primipara women pelvic floor muscle activity via EMG, during its resting period, and during its maximum voluntary contraction. Results: The PP muscle activation, measured by EMG, is superior in nulliparous women, both in CVM as at rest. However, these differences are only statistically significant during rest. Conclusion: Due to the small number of participants, it is not possible to confirm that the lacerations have a negative impact on muscular activation of the pelvic floor.
Description
Mestrado em Fisioterapia
Keywords
Pavimento pélvico Gravidez Parto Eletromiografia Fisioterapia Pelvic-floor Pregnancy Childbirth Electromyography Physiotherapy
Citation
Santos DV. Diferenças na ativação muscular do pavimento pélvico, entre mulheres com lacerações perineais decorrentes do parto e mulheres nulíparas [dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2020.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa