Banca de QUALIFICAÇÃO: JOYCE MARIA PEREIRA DE OLIVEIRA

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : JOYCE MARIA PEREIRA DE OLIVEIRA
DATE: 15/04/2025
TIME: 18:00
LOCAL: Videoconferência
TITLE:

Impact of a Semi-Supervised Exercise Protocol Via Telemonitoring on the Pelvic Floor Muscle Strength of Diabetic Pregnant Women

KEY WORDS:

Pelvic Floor; Exercise; Pregnant Women; Telemedicine.

PAGES: 50
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Pregnancy is a period of numerous transformations in a woman's body, impacting the pelvic floor muscles (PFM). Women with gestational diabetes mellitus (GDM) may be more vulnerable to pelvic floor dysfunctions (PFDs), such as urinary incontinence, due to the metabolic and biomechanical changes associated with the condition. The literature indicates that physical exercise promotes glycemic control, and when combined with pelvic floor muscle training (PFMT), it strengthens the PFM during pregnancy and postpartum, preventing PFDs. In this context, telemonitoring may enhance patient adherence and acceptability regarding both physical exercise and PFMT. Objective: To evaluate the impact of a semi-supervised exercise protocol via telemonitoring on PFM function in pregnant women with GDM. Methods: A randomized clinical trial was conducted with pregnant women receiving prenatal care at the Januário Cicco Maternity School. After confirming eligibility and obtaining consent, participants underwent a physical PFM assessment using vaginal manometry and the Modified Oxford Scale. A structured evaluation form was completed, including anamnesis and the following questionnaires: Pelvic Floor Distress Inventory (PFDI-20), Pelvic Floor Impact Questionnaire-Short Form 7 (PFIQ-7), International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), and the Female Sexual Function Index (FSFI). Participants were allocated into two groups: the Exercise Group (EG), which followed a structured protocol including general and specific PFM training with remote supervision, and the Comparator Group (CG), which received educational guidance through an informational booklet. Reassessment was conducted at 35–36 weeks of gestation, following the same initial procedures, with the addition of the Patient Global Impression of Change (PGI-C). Results: In the EG, the Modified Oxford Scale showed an improvement in PFM strength, with a reduction in the number of participants with lower strength levels (grade 2 decreased from 18.7% to 0%) and an increase in mean PFM pressure measured by vaginal manometry (from 27.7 cmH₂O to 33.3 cmH₂O). Regarding urinary symptoms assessed by the ICIQ- SF, the CG showed an increase in the "very severe" impact category from 18.7% to 33.3%, whereas the EG exhibited a decrease in the mean total score from 5.2 to 2.9, with "very severe" cases reducing from 31.3% to 13.3%. For the PFDI-20, the total score in the CG decreased from 34.9 to 28.1, while the EG showed a greater reduction from 56.7 to 41.7, indicating greater symptom improvement. In the PFIQ-7, the CG worsened from 0 to 7.1, while the EG showed a reduction from 19.0 to 9.5, reflecting positive effects. Regarding sexual function, both groups experienced a decrease in scores, indicating worsening, with a more pronounced decline in the CG (from 24.6 to 19.0). In the PGI-C, 62.5% of CG participants reported worsening, while in the EG, only 37.5% perceived deterioration. Conclusion: Preliminary data suggest that telemonitored semi-supervised exercise benefited pelvic floor function in women with GDM who adhered to the exercise program, leading to better outcomes compared to the comparator group.

COMMITTEE MEMBERS:
Externa ao Programa - 1242804 - ADRIANA GOMES MAGALHAES - nullExterna à Instituição - LEONY MORGANA GALLIANO - UO
Presidente - 2786809 - MARIA THEREZA ALBUQUERQUE BARBOSA CABRAL MICUSSI