Comparação dos efeitos do treinamento da musculatura do assoalho pélvico em gestantes realizado por aplicativo de celular e orientações escritas: Ensaio clínico randomizado

Abstract

Objective: The aim of this study was to compare the effect of different non-face-to-face pelvic floor muscle training (PFMT) modes performed during pregnancy on urinary and sexual issues. Methodology: This randomized controlled study included primiparous pregnant women without gestational alterations. The pregnant women were submitted to initial evaluation and after 12 weeks of intervention, by the questionnaires International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), Female Sexual Function Index (FSFI) and pelvic floor muscle strength (PFM) by digital palpation and contraction pressure by manometry. The participants were randomly divided into two groups: Group PFMT_app (n=8) and Group PFMT_primer (n=13). Both groups performed the same PFMT protocol. The program lasted 12 weeks, with weekly training frequency three times in the initial six weeks and four times in the last six weeks. The exercises were performed in different positions with decubitus progression and the amount of contractions and activation maintenance time being increased every 4 weeks. Results: No intra- or intergroup statistical differences were observed regarding the ICIQ-SF questionnaire (p>0.05), strength and pressure of contraction of PFM between groups or before and after interventions (p>0.05). Regarding sexual function, higher values were observed after the intervention in the PFMT_app group (p=0.039) when compared to PFMT_primer group. Conclusion: The PFMT guided by mobile application or written guidelines was effective to maintain the strength of PFMT and didn't change urinary complaints in pregnant women, and the guidance by cell application is superior for the maintenance of sexual function.