Efeitos do treinamento supervisionado e não supervisionado dos músculos do assoalho pélvico em mulheres com disfunção do assoalho pélvico

• Ano de defesa: 2026
• Autor(a) principal: Carvalho, Maria Letícia Araújo Silva de
• Orientador(a): Micussi, Maria Thereza Albuquerque Barbosa Cabral
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Rio Grande do Norte
• Programa de Pós-Graduação: PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS APLICADAS À SAÚDE DA MULHER
• País: BR
• Palavras-chave em Português: Diafragma da pelve; Assoalho pélvico; Disfunções do assoalho pélvico; Treinamento dos músculos do assoalho pélvico
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: https://repositorio.ufrn.br/handle/123456789/70105

Introduction: Pelvic floor dysfunctions, such as urinary incontinence (UI) and pelvic organ prolapse (POP), significantly impair women’s quality of life. Pelvic floor muscle training (PFMT) is considered a first-line, low-cost, and non-invasive treatment; however, adherence to supervised PFMT may be limited by logistical, financial, and personal barriers. Unsupervised PFMT may therefore represent a more accessible alternative. Objective: To compare the effects of supervised and unsupervised PFMT on pelvic floor muscle function and quality of life in women with UI and anterior POP. Methods: A randomized controlled trial was conducted including women diagnosed with UI and anterior vaginal wall POP. Assessments included sociodemographic and clinical data, pelvic floor muscle evaluation, and validated questionnaires: International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF), International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB), Pelvic Floor Distress Inventory (PFDI-20) and its subscales [Pelvic Organ Prolapse Distress Inventory (POPDI-6), Colorectal-Anal Distress Inventory (CRADI-8), and Urinary Distress Inventory (UDI-6)], World Health Organization Quality of Life (WHOQOL), Female Sexual Function Index (FSFI), and Patient Global Impression of Improvement (PGI-I). Participants were assessed at three time points: baseline, post-intervention, and one-month follow-up. They were randomly allocated to a supervised group (SG; n = 16), which performed in-person PFMT twice weekly for 16 sessions, or to an unsupervised group (UG; n = 16), which received educational materials and instructions to perform home-based exercises. Results: Thirty-two women were included in the analysis. Although no significant intergroup differences were observed for most outcomes, UDI-6 scores differed significantly between groups at both postintervention (SG: mean = 19.2; 95% CI: 9.9–28.5; UG: mean = 24.7; 95% CI: 15.4–34.0) and follow-up (SG: mean = 13.5; 95% CI: 4.2–22.8; UG: mean = 25.5; 95% CI: 16.2–34.8; p = 0.02), favoring the supervised group. Both groups demonstrated significant intragroup improvements over time in vaginal manometry, ICIQ-SF, PFDI20, and ICIQ-OAB (p < 0.001), with greater symptom reduction from baseline to followup. Conclusion: Both supervised and unsupervised PFMT resulted in clinically relevant improvements in pelvic floor muscle function and quality of life, with a tendency toward more pronounced effects in the supervised group. Additionally, unsupervised PFMT appears to be an effective and feasible alternative, with potential to enhance treatment adherence and expand access to pelvic floor rehabilitation services for women.