Pelvic-Floor Rehabilitation, Part 2 : Pelvic-Floor Reeducation With Interferential Currents and Exercise in the Treatment of Genuine Stress Incontinence in Postpartum Women : A Cohort Study

Background and Purpose. This descriptive cohort study investigated a physical therapy program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine stress incontinence (GSI). Subjects. Eight female subjects with urodynamically established GSI persisting more than 3 months after delivery participated in the study. The subjects ranged in age from 24 to 37 years (X̅=32, SD=4.2). Methods. This was a descriptive multiple-subject cohort study. Each subject received a total of nine treatment sessions during 3 consecutive weeks, consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic-floor muscle exercise program. Patients also practiced daily pelvic-floor exercises during the 3-week treatment period. The treatment intervention was measured using three separate variables. Maximum muscle contractions (pretraining, during training, and posttraining) were measured indirectly as pressure, using perineometry. Urine loss pretraining and posttraining was measured by means of a Pad test. Self-reported frequency of incontinence was recorded daily throughout the period of the study, using a diary. Data were analyzed using a one-way repeated measures analysis of variance (ANOVA), a Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks. Results. The results indicated that maximum pressure generated by pelvic-floor contractions was greater and both the quantity of urine loss and the frequency of incontinence were lower following the implementation of the physical therapy program. Five subjects became continent, and three others improved. A follow-up survey 1 year later confirmed the consistency of these results. Conclusion and Discussion. The results suggest that the proposed physical therapy program may influence postpartum GSI. Further studies are needed to validate this simple, inexpensive, and conservative physical therapy protocol.

Synchronizing the in vitro germination of Psidium guineense Sw. seeds by means of osmotic priming.

The Brazilian guava (Psidium guineense Swartz) is seed-propagated and, being native to the Caatinga biome, may frequently have uneven germination.Thus, we aimed to evaluate the synchronization of the in vitro seed germination of three accessions of the Brazilian guava, using water, polyethyleneglycol (PEG 6000), and potassium nitrate (KNO3) at different potentials and times of osmotic priming. Seeds from three accessions of the Brazilian guava (Y85, Y93,and Y97) from the UNEB/BA Germplasm Active Bank were subjected to the following pretreatments: -0.6, -1.0, -1.4, and -1,8 MPa PEG 6000; 10 and 20% KNO3 for 24h; 10 and 20% KNO3 for 48h; water for 24 and 48h; and non-primed seeds as the control. The experimental design was therefore a 10x3+1 factorial scheme. We assessed the germination percentage (G), mean germination time (MGT), germination speed (GS), and germination speed index (GSI). Data was subjected to analysis of variance followed by a means test (Duncan at 5% probability) and regression. There was interaction between the priming treatments and accessions for all evaluated features, except G. PEG 6000 decreased the MGT (from 6 to 8 days) and increased GS and GSI of seeds from all three accessions at potentials -1.0 to -1.5 MPa.Water-priming had a positive effect on MGT, GS, and GSI of accession Y85 seeds. KNO3 negatively affected germination of seeds from all three accessions. Thereby, we could synchronize seed germination of accessions Y85 and Y97 with PEG 6000.