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The influence of perineal training and type of delivery on multidirectional load distribution of the female pelvic floor

Grant number: 13/13820-6
Support Opportunities:Scholarships in Brazil - Doctorate
Effective date (Start): September 01, 2013
Effective date (End): August 01, 2017
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Isabel de Camargo Neves Sacco
Grantee:Licia Pazzoto Cacciari
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Associated scholarship(s):15/19679-9 - Alterações morfológicas do assoalho pélvico decorrentes do tratamento fisioterapêutico para incontinência urinaria medidas por meio do ultrassom transperineal, BE.EP.DR


The pelvic floor is a group of muscles, joints and fascia, forming the base of the abdomino-pelvic cavity, considered an understudied region of the body from a biomechanical perspective. Together these structures contribute to support the pelvic organs and to maintain urinary and fecal continence. Although 45% of the women are not capable to contract the pelvic floor voluntarily, the strength and the capacity to maintain the pelvic floor muscle contraction are related to the severity of incontinence and sexual satisfaction. The most established risk factor for pelvic floor dysfunction and weakening of the pelvic floor musculature is vaginal delivery. The aims of the present study are to: (1) investigate whether antepartum use of a birth trainer reduce pelvic floor weakness; and to (2) investigate the effect of a pompoir training practice on strength, endurance and coordination of these muscles. A multidirectional spatiotemporal load distribution of the pelvic floor will be assessed by a probe fully instrumented with capacitive sensors (Pliance System- Novel, Munich, Germany), and by a dynamometer instrumented with a strain gauge (EMG-system do Brasil 020653/ 2013 - São José dos Campos, SP/Brasil). To answer the first question, 20 primiparous women that went through vaginal labor with and without antepartum training; and to answer the second question 20 nulliparous that practiced or not the pompoir training will be assessed by the same protocol. After vaginal palpation, pelvic floor muscle strength will be evaluated during three consecutive maximal voluntary contractions and one sustained contraction. The variables will be compared between groups by analysis of variance (ANOVA) followed by Newman-Keuls post-hoc test. Alpha will be set at 0.05 for all analysis. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CACCIARI, LICIA P.; AMORIM, AMANDA C.; PASSARO, ANICE C.; DUMOULIN, CHANTAL; SACCO, ISABEL C. N.. Intravaginal pressure profile of continent and incontinent women. JOURNAL OF BIOMECHANICS, v. 99, . (13/19610-3, 13/13820-6)
CACCIARI, LICIA P.; PASSARO, ANICE C.; AMORIM, AMANDA C.; GEUDER, MANFRED; SACCO, ISABEL C. N.. Novel instrumented probe for measuring 3D pressure distribution along the vaginal canal. JOURNAL OF BIOMECHANICS, v. 58, p. 139-146, . (13/19610-3, 15/19679-9, 13/13820-6)
CACCIARI, LICIA P.; PASSARO, ANICE C.; AMORIM, AMANDA C.; SACCO, ISABEL C. N.. High spatial resolution pressure distribution of the vaginal canal in Pompoir practitioners: A biomechanical approach for assessing the pelvic floor. CLINICAL BIOMECHANICS, v. 47, p. 53-60, . (13/19610-3, 13/13820-6)
Academic Publications
(References retrieved automatically from State of São Paulo Research Institutions)
CACCIARI, Licia Pazzoto. Investigation of the multivectorial load distribution of the pelvic floor in different female populations. 2017. Doctoral Thesis - Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) São Paulo.

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