Influence of parity, type of delivery, and physical activity level on pelvic floor muscles in postmenopausal women

Larissa Ramalho Dantas Varella, Vanessa Braga Torres, Priscylla Helouyse Melo Angelo, Maria Clara Eugênia de Oliveira, Alef Cavalcanti Matias de Barros, Elizabel de Souza Ramalho Viana, Maria Thereza de Albuquerque Barbosa Cabral Micussi, Larissa Ramalho Dantas Varella, Vanessa Braga Torres, Priscylla Helouyse Melo Angelo, Maria Clara Eugênia de Oliveira, Alef Cavalcanti Matias de Barros, Elizabel de Souza Ramalho Viana, Maria Thereza de Albuquerque Barbosa Cabral Micussi

Abstract

[Purpose] The aim of the present study was to assess the influence of parity, type of delivery, and physical activity level on pelvic floor muscles in postmenopausal women. [Subjects and Methods] This was an observational analytic cross-sectional study with a sample of 100 postmenopausal women, aged between 45 and 65 years, divided into three groups according to menopausal stage: hysterectomized and early and late postmenopause. Patients were assessed for sociodemographic and gyneco-obstetric factors and subjected to a muscle strength test and perineometry. Descriptive statistics, ANOVA, Kruskal-Wallis and multiple regression were applied. [Results] The results showed homogeneity in sociodemographic and anthropometric characteristics. There was no difference in pelvic floor muscle function among the three groups. Type of delivery, parity and physical activity level showed no influence on muscle function. [Conclusion] The findings demonstrate that parity, type of delivery, and physical activity level had no influence on pelvic floor muscle pressure in postmenopausal women. One hypothesis to explain these results is the fact that the decline in muscle function in postmenopausal women is related to the female aging process.

Keywords: Aging; Muscle strength; Physical examination.

References

    1. Gold EB: The timing of the age at which natural menopause occurs. Obstet Gynecol Clin North Am, 2011, 38: 425–440.
    1. Whitham HK, Maclehose RF, Harlow BL, et al. : Assessing the utility of methods for menopausal transition classification in a population-based cohort: the CARDIA Study. Maturitas, 2013, 75: 289–293.
    1. Harlow SD, Gass M, Hall JE, et al. STRAW 10 Collaborative Group: Executive summary of the stages of reproductive aging workshop + 10: addressing the unfinished agenda of staging reproductive aging. Menopause, 2012, 19: 387–395.
    1. Mishra GD, Cardozo L, Kuh D: Menopausal transition and the risk of urinary incontinence: results from a British prospective cohort. BJU Int, 2010, 106: 1170–1175.
    1. Higal R, Lopes MH, Reis MJ: Fatores de risco para incontinência urinária na mulher. Rev Esc Enferm USP, 2006, 42: 187–192.
    1. Hansen BB, Svare J, Viktrup L, et al. : Urinary incontinence during pregnancy and 1 year after delivery in primiparous women compared with a control group of nulliparous women. Neurourol Urodyn, 2012, 31: 475–480.
    1. Memon H, Handa VL: Pelvic floor disorders following vaginal or cesarean delivery. Curr Opin Obstet Gynecol, 2012, 24: 349–354.
    1. Kim H, Shim J, Kim B: Analysis of vaginal pressure and abdominal EMG according to delivery method during pelvic floor. J Phys Ther Sci, 2012, 24: 119–121.
    1. MacLennan AH, Taylor AW, Wilson DH, et al. : The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery. BJOG, 2000, 107: 1460–1470.
    1. Rortveit G, Hannestad YS, Daltveit AK, et al. : Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynecol, 2001, 98: 1004–1010.
    1. Bø K: Urinary incontinence, pelvic floor dysfunction, exercise and sport. Sports Med, 2004, 34: 451–464.
    1. Danforth KN, Shah AD, Townsend MK, et al. : Physical activity and urinary incontinence among healthy, older women. Obstet Gynecol, 2007, 109: 721–727.
    1. Thyssen HH, Clevin L, Olesen S, et al. : Urinary incontinence in elite female athletes and dancers. Int Urogynecol J Pelvic Floor Dysfunct, 2002, 13: 15–17.
    1. Matsudo S, Araujo T, Matsudo V, et al. : Questionário internacional de atividade física (IPAQ): estudo de validade e reprodutibilidade no Brasil. Rev Bras Ativ Fis Saude, 2001, 6: 5–18.
    1. Barbosa PB, Franco MM, Souza FO, et al. : Comparison between measurements obtained with three different perineometers. Clinics (Sao Paulo), 2009, 64: 527–533.
    1. Laycock J: Clinical guidelines for the physiotherapy management of females aged 16–65 years with stress urinary incontinence. London: Chartered Society of Physiotherapy, 2001.
    1. Ferreira CH, Barbosa PB, de Oliveira Souza F, et al. : Inter-rater reliability study of the modified Oxford Grading Scale and the Peritron manometer. Physiotherapy, 2011, 97: 132–138.
    1. Da Roza T, Mascarenhas T, Araujo M, et al. : Oxford Grading Scale vs. manometer for assessment of pelvic floor strength in nulliparous sports students. Physiotherapy, 2013, 99: 207–211.
    1. Moreira EC, Arruda PB: Força muscular do assoalho pélvico entre mulheres continentes jovens e climatéricas. Semina Cienc Biol Saude, 2010, 31: 53–61.
    1. Pereira VS, Correia GN, Driusso P: Individual and group pelvic floor muscle training versus no treatment in female stress urinary incontinence: a randomized controlled pilot study. Eur J Obstet Gynecol Reprod Biol, 2011, 159: 465–471.
    1. Pereira VS, de Melo MV, Correia GN, et al. : Long-term effects of pelvic floor muscle training with vaginal cone in post-menopausal women with urinary incontinence: a randomized controlled trial. Neurourol Urodyn, 2013, 32: 48–52.
    1. Schettino MT, Mainini G, Ercolano S, et al. : Risk of pelvic floor dysfunctions in young athletes. Clin Exp Obstet Gynecol, 2014, 41: 671–676.
    1. Borin LC, Nunes FR, Guirro EC: Assessment of pelvic floor muscle pressure in female athletes. PM R, 2013, 5: 189–193.
    1. Nygaard IE, Shaw JM, Bardsley T, et al. : Lifetime physical activity and female stress urinary incontinence. Am J Obstet Gynecol, 2015, 213: 40.e1–40.e10.
    1. Virtuoso JF, Mazo GZ, Menezes EC: Urinary incontinence and perineal muscle function in physically active and sedentary elderly women. Rev Bras Fisioter, 2011, 15: 310–317.
    1. Vinsnes AG, Helbostad JL, Nyrønning S, et al. : Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes. Clin Interv Aging, 2012, 7: 45–50.
    1. Horak TA, Guzman-Rojas RA, Shek KL, et al. : Pelvic floor trauma: does the second baby matter? Ultrasound Obstet Gynecol, 2014, 44: 90–94.
    1. Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, et al. : Pelvic floor muscle function in a general female population in relation with age and parity and the relation between voluntary and involuntary contractions of the pelvic floor musculature. Int Urogynecol J Pelvic Floor Dysfunct, 2009, 20: 1497–1504.
    1. Özdemır ÖC, Bakar Y, Özengın N, et al. : The effect of parity on pelvic floor muscle strength and quality of life in women with urinary incontinence: a cross sectional study. J Phys Ther Sci, 2015, 27: 2133–2137.
    1. Yang JM, Yang SH, Huang WC, et al. : Factors affecting reflex pelvic floor muscle contraction patterns in women with pelvic floor disorders. Ultrasound Obstet Gynecol, 2013, 42: 224–229.
    1. Eogan M, O’Brien C, Daly L, et al. : The dual influences of age and obstetric history on fecal continence in parous women. Int J Gynaecol Obstet, 2011, 112: 93–97.
    1. Chantereau P, Brieu M, Kammal M, et al. : Mechanical properties of pelvic soft tissue of young women and impact of aging. Int Urogynecol J Pelvic Floor Dysfunct, 2014, 25: 1547–1553.
    1. Basualto-Alarcón C, Varela D, Duran J, et al. : Sarcopenia and androgens: a link between pathology and treatment. Front Endocrinol (Lausanne), 2014, 5: 217.
    1. Pöllänen E, Sipilä S, Alen M, et al. : Differential influence of peripheral and systemic sex steroids on skeletal muscle quality in pre- and postmenopausal women. Aging Cell, 2011, 10: 650–660.
    1. Micussi MT, Freitas RP, Angelo PH, et al. : Is there a difference in the electromyographic activity of the pelvic floor muscles across the phases of the menstrual cycle? J Phys Ther Sci, 2015, 27: 2233–2237.

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