Promoção da saúde de mulheres com incontinência urinária: aprendizagem da contração da musculatura do assoalho pélvico

Abstract

Introduction: Urinary incontinence does not directly endanger women's lives, however, it becomes a problem that can compromise quality of life, body image, social relationships, affecting women physically and psychologically. Objective: The present study aimed to verify the effectiveness of physical therapy exercises applied to the pelvic floor muscles in women with reported loss of urine. Method: Before and after intervention study. The population consisted of women with reported urinary incontinence. The Body Shape Questionnaire (BSQP) instrument was used to assess body image and the King’s Health Questionnaire (KHQ), which aims to assess the quality of life of this elderly woman, in addition to questions for the characterization of the population. The intervention consisted of 12 sessions with guidelines for performing exercises to strengthen the pelvic floor musculature, to minimize the loss of urine on exertion. The sessions took place remotely via Google Meet, twice a week, lasting 20 minutes. Results: The population is mostly over 50 years old (58.33%), married / in a stable relationship (79.17%), with complete higher education (66.67%), almost half have a family income of 3 to 6 minimum wages (45.83%). One-third are of normal weight (33.33%), half of whom were classified as overweight using BMI (50.00%). Regarding quality of life, among the domains that had the worst scores were general health perception (mean 36.46), followed by the impact of incontinence (mean 36.11 points) the domains of physical limitations and measures of severity also showed the same median value. Although these were the worst scores, in general, the KHQ scores were considered good. Statistically significant difference was observed before and after the intervention for the domains of general health perception (p-value of 0.023), limitations of daily activities (p-value of 0.047), sleep and disposition (p-value of 0.048), and measures of severity (0.023) of the KHQ instrument, however, all domains showed reduced scores, which is positive since lower scores indicate better quality of life. Regarding body image, it was found that there was a significant difference between the scores before and after the intervention in the patients (p = 0.033). Conclusion: Pelvic floor kinesiotherapy, through strengthening training, proved to be effective in improving QoL and body image domains, an exercise program and health guidelines related to UI can be a very effective alternative; non-invasive and less costly for the prevention, treatment of urinary incontinence as well as to promote the health of this group, with a positive impact directly on QOL and body image