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Previous issue date: 2015-11-10 / A p?s-menopausa caracteriza-se por altera??es hormonais e org?nicas decorrentes da fal?ncia ovariana, destacando-se as altera??es na musculatura do assoalho p?lvico (MAP). Tem-se na literatura atual que, em mulheres jovens, fatores gineco-obst?tricos e h?bitos de vida influenciam nessa perda de fun??o, no entanto, ainda h? incertezas sobre a influ?ncia dessas vari?veis no funcionamento da MAP de mulheres na p?s-menopausa. Assim, o presente estudo visou avaliar se h? influ?ncia da paridade, tipo de parto e n?vel de atividade f?sica sobre a MAP em mulheres na p?s-menopausa. Objetivou-se ainda comparar a for?a da MAP em mulheres na p?s-menopausa submetidas a parto normal e ces?rea, com diferentes n?veis de atividade f?sica, e com menopausa artificial e natural nas fases inicial e tardia, al?m de correlacionar o teste de for?a muscular e perineometria e analisar a confiabilidade inter-examinador da perineometria. Atrav?s de um estudo observacional, anal?tico e transversal foram estudadas 100 mulheres no per?odo da p?s-menopausa, com idades entre 45 e 65 anos, divididas, de acordo com o estado menopausal, em tr?s grupos: histerectomizadas, p?s-menopausa inicial e tardia. As pacientes foram questionadas sobre fatores sociodemogr?ficos e hist?ria gineco-obst?trica. Todas as volunt?rias foram submetidas ao exame f?sico, no qual foi mensurado o peso e altura para c?lculo do ?ndice de massa corporal e a circunfer?ncia cintura. A avalia??o do assoalho p?lvico foi realizada investigando a for?a e a press?o da MAP por meio do teste de for?a muscular e da perineometria. Para an?lise dos resultados foram utilizados a estat?stica descritiva, os testes de compara??o como ANOVA e a regress?o m?ltipla, al?m do teste Kolmogorov-Smirnov aplicado para testar a normalidade das vari?veis. Nos resultados, observou-se que em rela??o ?s caracter?sticas sociodemogr?ficas e antropom?tricas na amostra final (n = 85). Sendo observado que a maioria das mulheres nos tr?s grupos eram casadas (p=0.51) e cat?licas (p=0.13). A renda per capta variou de R$ 585,47 ? 466,67 a R$1.271,83 ? 1.748,97, sendo sem signific?ncia a diferen?a entre os grupos (p=0.05). O G>6apresentou uma m?dia de idade de 58,95 ?3,96 significativamente maior que o G<6 (53,21? 3,88) (p=0.000). Quanto as caracter?sticas antropom?tricas, n?o houve diferen?a entre os grupos em rela??o ao peso (p=0.32), altura (p=0.72), IMC (p=0.34) e circunfer?ncia de cintura (p=0.33). Obteve-se que o tipo de parto, paridade e n?vel de atividade f?sica n?o apresentaram influ?ncia sobre a fun??o da musculatura do assoalho p?lvico nas mulheres estudadas (p= 0.794). N?o foram vistas diferen?as na fun??o da MAP de mulheres submetidas a partos normais, cesarianos e normais + cesarianos (TFM p= 0.897; perineometria p = 0.502), de mulheres com 1 parto, 2-3 partos ou 4 partos ou mais (TFM p=0.28; perineometria p=0.13), e entre aquelas com diferentes n?veis de atividade f?sica (TFM p= 0.663; perineometria p=0.741) Acredita-se que o decl?nio da fun??o muscular em mulheres na p?s-menopausa esteja relacionado, fundamentalmente, ao processo de envelhecimento feminino. / The post-menopause stage is characterized by hormonal and organic alterations of ovarian failure. One of the most important of these is muscles alterations of the pelvic floor (MPF). According to current literature, in young women gynecological and obstetric factors, as well as lifestyles and habits influence that loss of function. However, there is still uncertainty about the influence of those variables in the MPF functions in post-menopause women. Thus, this study aimed at seeing if there is an influence from number of births, the type of birth and the level of physical activity on the MPF of post-menopause women. Another objective of this study was to compare MPF force in women who had had vaginal births with those who had been subjected to cesarean sections, those with different levels of physical activity and those with artificial and natural menopause in the initial and latter stages. Furthermore, the test of muscular force was compared to perineometry. Using observational, analytical and transversal observations, 100 women in the post-menopausal stage of life, between the ages of 45 and 65, were examined. They were divided according to the menopausal stage into three groups: women who had undergone hysterectomies, those in the initial stages of postmenopause and those in the late stage of postmenpause. The patients were questioned about social, demographic, gynecological and obstetric factors. All the volunteers were submitted to a physical examination where their height and weight were measured to arrive at the corporal mass index and their waist measurements were taken. The evaluation of the pelvic floor was conducted with muscular force tests and perineometry. These results were analyzed with statistical description and ANOVA statistical tests, multiple regression and Kolmogorov-Smirnov evaluations. The results showed homogeneity with regard to social demographic and anthropometric characteristics among the women in the final test sample (n=85). It was also seen that most of the women in all three groups were married (p=0.51) and catholic (p=0.13). The average per capital income varied between $R585.47 (+/-466.67) and $R1,271.83 (+/-1,748.95), with no significant difference between the groups (p=0.05). The G>6 group presented an average age between 58.95 (+/-3.96) which was significantly greater that the G<6 group?s average age (53.21+/- 3.88) (p=0.000). There was no difference between the groups? anthropometric characteristics of weight (p=0.32), height (p=0.72) and corporal mass index (p=0.34), nor in the waist measurements (p=0.33). Furthermore, no significant difference was noted in the MPF function of women who had had normal births, cesarean sections or a combination of the two (TFM p=0.897; perineum measurement p=0.502). Likewise, no differences were seen in the MPF function of women who had one, two to three or four or more births (TFM p=0.28, perineum measurement p=0.13). Finally, no difference was perceived among those with different levels of physical activity (TFM p=0.663; perineum measurement p=0.741). Therefore, we found that the type of delivery, number of births and physical activity had no influence on the muscular function of the pelvic floor among the women studied. It is believed that decline in muscular function in post-menopause women is fundamentally related to the process of aging.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/20736 |
| Date | 10 November 2015 |
| Creators | Varella, Larissa Ramalho Dantas |
| Contributors | 04566613445, http://lattes.cnpq.br/2360845979410206, Viana, Elizabel de Souza Ramalho, 35887044420, http://lattes.cnpq.br/2081849934383112, Costa, Karla Veruska Marques Cavalcante da, 02706590483, http://lattes.cnpq.br/1142023017602694, Micussi, Maria Thereza Albuquerque Barbosa Cabral |
| Publisher | Universidade Federal do Rio Grande do Norte, PROGRAMA DE P?S-GRADUA??O EM FISIOTERAPIA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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