Avaliação cardiorrespiratória no repouso e no exercício em mulheres com incontinência urinária
Jürgensen, Soraia Pilon
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INTRODUCTION: Urination is mainly controlled by the sympathetic nervous system (SNS), responsible for continence mechanism, and parasympathetic (PNS). The evaluation of cardiac autonomic modulation (CAM) by heart rate variability (HRV) may be inferred autonomic imbalance related to urination. OBJECTIVE: to compare the CAM in response to postural changes in women with and without urinary incontinence (UI). METHODS: participants were placed into two groups: with UI (UIG) (n=30; 53±9 years) and control group (CG) (n=22, 53±12 years). There were no included women with cardiovascular disease, with urogynecological surgeries, smokers, diabetics, alcoholics, drug users affecting the responses of variables. It was carried out: anamnesis (including questionnaire that quantifies the degree of urinary loss), functional evaluation of the pelvic floor, evaluation of HRV during postural change, provided with a full bladder (FB) and an empty bladder (EB). HRV was analyzed by linear and nonlinear techniques. Was performed student t test for comparison between groups was applied to two-way ANOVA for comparison between the situations (FB and EB) and positions (supine and standing), and Pearson correlation. RESULTS: there was no significant difference between groups for demographic, anthropometric and functional evaluation of the pelvic floor data. Supine and EB, the UIG showed lower sympathetic modulation and overall HRV compared to CG (%0V:12±8 and 17±8, and SD2:33±13 and 44±17, respectively UIG and CG). There was a significant correlation between the degree of UI with the representative indices of SNS and PNS in this condition (%0V: r=-0.38; p=0.037% and 2UV:r=0.32; p=0.048). Comparing the situations during the supine, both groups had lower overall HRV (SD1:FB=15±5, EB=16±5; FB=15±5, EB=17±5, respectively UIG and CG) and UIG greater imbalance autonomic (%1V:FB=49±7, EB=46±5), with FB. CONCLUSION: UIG presented change in the CAM in relation to CG; and the representative indices of SNS and PNS correlated with the severity of UI, suggesting greater autonomic impairment.