MAPAPP: proposta de um aplicativo de celular para treinamento dos músculos do assoalho pélvico em gestantes

Abstract

Introduction: Pelvic floor muscle training (PFMT) is recommended as a first-line therapy for the treatment and prevention of pelvic floor disorders in pregnancy and postpartum. Therefore, it is important to encourage the performance of these exercises before, during and after the gestational process so that the functional conditioning of the pelvic floor muscles is maintained. The increase in people with access to mobile phones in recent years has stimulated the development of alternative measures for self-management of health. Aim: To develop, validate and verify the effects of a mobile device application to guide pelvic floor muscle training in primiparous women. Method: Randomized clinical trial based on the construction of a mobile device application with the aim of expanding access to information on perineal and gestational health and a TMAP protocol. The application was named Meu Assoalho Pelvic (MAPapp), developed in Dart language, flutter framework, using the Mysql database, available in the Android version. The construction process was carried out in four stages with the participation of physical therapists. To assess the effects of using PFMT with the use of MAPapp, 125 were randomized into 3 groups: App Group (PFMT guided by a cell phone application); Sup+Esc Group (PFMT supervised online twice a week and written exercise guidelines); and Sup+App Group (PFMT supervised online twice a week and application use). Before and 12 weeks after the intervention, the participants were evaluated by the Female Sexual Function Index and the International Urinary Incontinence Questionnaire, in addition to a satisfaction questionnaire. Results: One hundred twenty-two participants provided outcome data. After the intervention, there was no significant difference in urinary complaints and total sexual function score in the three intervention groups. The App group had the lowest average number of training sessions (30.75 + 6.36), and the participants who had access to the app had a higher level of satisfaction (p< 0.01).Conclusion: Users of the MAPapp application had little difficulty and high satisfaction in using the tool. The groups of different types of PFMT guidance had the same effects in maintraining urinary and sexual complaints which corroborates the scientific recommendations on perfoming perineal exercises during pregnancy. Despite the high satisfaction rate of the App group, it showed the lowest adherence to the exercise program.