Análise crítica dos exercícios de fortalecimento do assoalho pélvico na gravidez
DOI:
https://doi.org/10.33233/fb.v8i3.1774Abstract
Na gravidez ocorre redução da performance de vários grupamentos musculares, incluindo aqueles do assoalho pélvico. Visto o importante papel da musculatura do assoalho pélvico sobre os mecanismos da continência urinária, justifica-se a preocupação com a busca de intervenções que possam realmente amenizar ou reverter os efeitos da gravidez sobre a sua função. O treinamento dos músculos do assoalho pélvico quando realizado na gravidez, poderia aumentar a força desse grupo muscular e prevenir a incontinência urinária tanto na gestação quanto no pós-parto. Além disto, espera-se que estas intervenções possam reduzir o período expulsivo do parto e a ocorrência de trauma perineal. O objetivo deste artigo foi analisar criticamente os resultados dos estudos que investigaram as repercussões de programas de treinamento dos músculos do assoalho pélvico na gravidez. Sabe-se que investigações sistematizadas sobre esse tema ainda são escassas e os resultados controversos, não permitindo afirmar que o treinamento da musculatura do assoalho pélvico pode proporcionar ganho de força muscular. Entretanto, existem fortes indícios de que as taxas de incontinência urinária poderiam ser reduzidas por meio desses programas.
 Palavras-chave: assoalho pélvico, gravidez, exercício físico, treinamento, incontinência urinária.
References
Fast A, Weiss L, Ducommun EJ, Medina E, Butler JG. Low-back pain in pregnancy. Abdominal muscles, sit-up performance, and back pain. Spine 1990;15(1):28-30.
Gilleard WL, Brown JM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. Phys Ther 1996;76(7):750-62.
Fleming N, Newton FR, Roberts J. Changes in postpartum perineal muscle function in women with and without episiotomies. J Midwifery Womens Health 2003;48(1):53-9.
Treuth MS, Butte NE, Puyau M. Pregnancy related changes in physical activity, fitness, and strength. Med Sci Sports Exerc 2005;37(5):832-7.
Morkved S, Salvesen A, Bo K, Eik-Nes S. Pelvic Floor muscle strength and thickness in continent and incontinent nulliparous pregnant women. Int Urogynecol J 2004;15:384-90.
Bo K, Sherburn M. Evaluation of female pelvic-flor muscle function and strength. Phys Ther 2005;85(3):269-282.
Bernstein IT. The pelvic floor muscles: muscle thickness in healthy and urinary incontinent women measured by perineal ultrasonography with reference to the effect of pelvic floor training. Neurourol Urodyn 1997;16(4):237-75.
Sampeselle CM, Miller JM, Mims BL, Delancey JOL, Ashton-Miller JA, Antonakos CL. Effect of pelvic muscle exercise on transient incontinence during pregnancy and after birth. Obstet Gynecol 1998;91(3):406-12.
Reilly ETC, Freeman RM, Waterfield AE, Steggles P, Pedlar F. Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: a randomized controlled trial of antenatal pelvic floor exercises. BJOG 2002;109:68-76.
Morkved S, BO K, Schei B, Salvensen KA. Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial. Obstet Gynecol 2003; 101(2):313-19.
Salvensen KA, Morkved S. Randomised controlled trial of pelvic floor muscle training during pregnancy. BMJ 2004;329:378-80.
McDonald AD, McDonald JC, Armstrong B et al. Prematurity and work in pregnancy. Br J Ind Med 1988;45:56-62.
Misra DP, Strobino DM, Stashinko EE, Nagery DA, Nanda J. Effects of physical activity on preterm birth. Am J Epidemiol 1998;147(7):628-35.
Badr LK, Abdallah B, Mahmoud A. Precursors of preterm birth: comparison of three ethnic groups in the Middle East and the United States. J Obstet Gynecol Neonatal Nurs 2005;34(4):444-52.
Clapp JF. Exercise during pregnancy. A clinical update. Clin Sports Med 2000 19(2):273-86.
Klebanoff MA, Shiono PH, Carey JC. The effect of physical activity during pregnancy on preterm delivery and birth weight. Am J Obstet Gynecol 1990; 163(5):1450-6.
Hatch MC, Shu X-O, McLean DE, et al. Maternal exercise during pregnancy, physical fitness and fetal growth. Am J Epidemiol 1993;137:1105-14
Sternfeld B. Physical activity and pregnancy outcome. Review and recommendations. Sports Med 1997;23(1):33-47.
Kardel KR, Kase T. Training in pregnant women: effects on fetal development and birth. Am J Obstet Gynecol 1998;178(2):280.
Leiferman JA, Everson KR. The effect of regular leisure physical activity on birth outcomes. Matern Child Health J 2003;7(1):59-64.
Artal R, O`Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.
Br J Sports Med 2003;37(1):6-12.
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