Incontinência urinária, função sexual e qualidade de vida em mulheres com mais de 60 anos: qual abordagem remota síncrona é mais eficaz, ginástica feminina feita em grupo ou individualmente? um estudo piloto controlado randomizado

Abstract

Introduction: Urinary incontinence (UI) is defined as any involuntary loss of urine, which affects approximately 25% of the general population. The prevalence is higher in women and increases with age. The high prevalence of UI in elderly women is due to factors associated with the physiology of the elderly, such as loss of strength in the pelvic floor muscles and changes in detrusor muscle. Pelvic floor muscle training (PFMT) is an effective, low-cost and non-invasive treatment that improves UI symptoms, especially urinary losses due to effort. In addition to changes in lower urinary tract, aging can also interfere with women's sexuality, due to different and multifactorial causes of biopsychosocial order. Changes in the pelvic floor muscles, mainly caused by the arrival of menopause, pregnancies and childbirth, can impair sexual performance. The TMAP is one of the therapeutic strategies that can reduce complaints related to women's sexual life, and promote an improved quality of sexual life. Objective: To improve quality of life, sexual function and urinary incontinence of women over 60 years old. Method: a pilot, experimental, randomized and controlled study carried out in a synchronous online way, with 32 women, divided into three groups: control group, individual Women's Gymnastics and Group Women's Gymnastics, who participated in the intervention during five weekly meetings. They were assessed using questionnaires for UI (ICIQ-sf and KHQ) and sexual function (FSFI) before and after the intervention. Results: Women in the individual Women's Gymnastics group showed a decrease in the mean ICIQ-sf score from 6 at baseline to 4.25 after five weeks. Regarding sexuality, according to the FSFI, all participants had sexual dysfunction, both at baseline and after five weeks. There was no significant difference in the domains that addressed UI and quality of life. In the sexual function domains there was a difference between the Individual Women's Gymnastics intervention and the control group, in the lubrication (p 0.0028) and satisfaction (p 0.0119) domains, indicating that there was a significant difference between these two groups. Conclusion: a synchronous online exercise program, focusing on body awareness and training of the pelvic floor muscles was able to promote health for women over 60 years old, with its benefits demonstrated through the decrease in the averages of the ICIQ-sf score, mainly in individual Women's Gymnastics group.