Physiotherapeutic intervention in the immediate puerperium: What are the evidences in the last decade?
DOI:
https://doi.org/10.33448/rsd-v10i3.12849Keywords:
Postpartum Period; Physical Therapy Specialty; Physical Therapy Modalities; Evidence-Based Practice.Abstract
Objective: To analyze the scientific production of the last ten years, regarding the physiotherapeutic activity in the immediate puerperium and the evidence of this practice. Methods: Exploratory research of the bibliometric type, carried out through a literature review in PubMed/Medline, Web of Science, Scopus, PEDro and LILACS databases, on the physiotherapeutic performance in the immediate puerperium published in the last decade. The following descriptors were used: “postpartum”; “puerperium” and “physiotherapy”. Results: Of 814 publications, only 17 were analyzed after exclusion of certain productions according to previously defined criteria. Prevailed the quantitative studies in English, carried out in Brazil, published in the last 5 years in journals with a low SJR impact factor, which addressed the themes of evaluation and treatment of rectus abdominis diastasis (RAD), followed by the use of transcutaneos electrostimulation (TENS) for immediate postpartum pain relief and pelvic floor musculature training (PFM). Conclusion: The scientific evidence pointed as the main physiotherapeutic interventions used in the immediate puerperium exercises for RAD, PFM and TENS, but the studies present low methodological rigor and were published in periodicals with low impact factor. It is suggested that new studies with greater methodological rigor be carried out only for women in the immediate puerperium to produce scientific evidence of better quality.
References
Alves EMS, Rabêlo TN, Santos MGR, Souza IG, Lima PAL, Santana LS. (2015). Transcutaneous electric nerve stimulation for post-Cesarean section analgesia. Revista Dor, 16(4): 263-6. https://doi.org/10.5935/1806-0013.20150053.
Andrade RD, Santos JS, Maia MAC, Mello DF. (2015). Fatores relacionados à saúde da mulher no puerpério e repercussões na saúde da criança. Escola Anna Nery Revista de Enfermagem, 19(1), 181-6. https://doi.org/10.5935/1414-8145.20150025.
Araújo CA. (2006). Bibliometria: evolução histórica e questões atuais. Em questão, 12(1): 11-32. https://seer.ufrgs.br/EmQuestao/article/view/16/5.
Ashrafinia F, Mirmohammadali M, Rajabi H, Kazemnejad A, Haghighi KS, Amelvalizadeh M. (2015). Effect of Pilates exercises on postpartum maternal fatigue. Singapore Medical Journal, 56(3), 169-73. DOI: 10.11622/smedj.2015042.
Ashrafinia F, Mirmohammadali M, Rajabi H, Kazemnejad A, Sadeghniiathaghighi K, Amelvalizadeh M, Chen, H. (2013). The effects of Pilates exercise on sleep quality in postpartum women. Journal of Bodywork and Movement Therapies, 18(2): 190-9. https://doi.org/10.1016/j.jbmt.2013.09.007.
Beleza ACS, Ferreira CHJ, Driusso P, Dos Santos CB, Nakano AMS. (2017). Effect of cryotherapy on relief of perineal pain after vaginal childbirth with episiotomy: a randomized and controlled clinical trial. Physiotherapy, 103(4): 453-8. https://doi.org/10.1016/j.physio.2016.03.003.
Bobowik PŻ, Dąbek A. (2018). Physiotherapy in women with diastasis of the rectus abdominis muscles. Advances in Rehabilitation, (3): 11-7. https://doi.org/10.5114/areh.2018.80964.
Brasil. (2011). Política Nacional de Atenção Integral à Saúde da Mulher: Princípios e diretrizes. Brasília: Ministério da saúde, Secretaria de Atenção à Saúde. https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_mulher_principios_diretrizes.pdf.
Burti JS, Cruz JPS, Silva AC, Moreira IL. (2016). Assistência ao puerpério imediato: o papel da fisioterapia. Revista da Faculdade de Ciências Médicas de Sorocaba, 18(4): 193-8. https://doi.org/10.5327/Z1984-4840201625440.
Crockett KL, Bowen A, Madill SJ, Kumaran M, Epp C, Graham AM. (2018). A review of the effects of physical therapy on self-esteem in postpartum women with lumbopelvic dysfunction. Journal of Obstetrics and Gynaecology Canada, 40(11), 1-12. https://www.jogc.com/article/S1701-2163(18)30589-9/fulltext.
Evenson KR, Mottola MF, Owe KM, Rousham EK, Brown WJ. (2014). Summary of international guidelines for physical activity following pregnancy. Obstetrical & Gynecological Survey, 69(7), 407-14. DOI: 10.1097/OGX.0000000000000077.
Falcão KPM, Carvalho ACF de, Marques ACML, Vieira AG, Barros JD, Rolim RB. (2015). Prevalência de alterações posturais em puérperas frente ao posicionamento durante a amamentação. Revista de Enfermagem UFPE on line, 9(11), 9839-45. https://doi.org/10.5205/1981-8963-v9i11a10776p9839-9845-2015.
Gardenghi LA, Dezotti NR, Dalio MB, Joviliano EE, Piccinato CE. (2017). Gestational lower limb edema and venous reflux in healthy primigravidae. International Angiology, 36(6), 569-73. DOI: 10.23736/S0392-9590.17.03865-2.
Goyal RC, Banginwar AS, Ziyo F, Toweir AA. (2011). Breastfeeding practices: positioning, attachment (latch-on) and effective suckling - A hospital-based study in Libya. Journal of Family & Community Medicine, 18(2), 74-9. https://www.jfcmonline.com/article.asp?issn=2230-8229;year=2011;volume=18;issue=2;spage=74;epage=79;aulast=Goyal.
Haran C, Van Driel M, Mitchell BL, Brodribb WE. (2014). Clinical guidelines for postpartum women and infants in primary care-a systematic review. BMC Pregnancy and Childbirth, 14(1), 1-9. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-51.
Kayman-Kose S, Arioz DT, Toktas H, Koken G, Kanat-Pektas M, Kose M, Yilmazer M. (2014). Transcutaneous electrical nerve stimulation (TENS) for pain control after vaginal delivery and cesarean section. The Journal of Maternal-Fetal & Neonatal Medicine, 27(15): 1572-5. https://doi.org/10.3109/14767058.2013.870549.
Lavand'homme P. (2013). Chronic pain after childbirth. Current Opinion in Anesthesiology, 26(3): 273-7. https://journals.lww.com/co-anesthesiology/Abstract/2013/06000/Chronic_pain_after_childbirth.5.aspx.
Lemos A, Souza AI, Andrade AD, Figueiroa JN, Filho JEC. (2011). Pregnancy inter-recti abdominis distance has no impact on respiratory strength. Journal of Physical Therapy Science, 23(5), 757–60. https://doi.org/10.1589/jpts.23.757.
Machado RN. (2007). Análise cientométrica dos estudos bibliométricos publicados em periódicos da área de biblioteconomia e ciência da informação (1990-2005). Perspectivas em Ciência da Informação, 12(3); 2-20. https://doi.org/10.1590/S1413-99362007000300002.
Martinez-Pulgarin DF, Acevedo-Mendoza WF, Cardona-Ospina JA, Rodríguez-Morales AJ, Paniz-Mondolfi AE. (2016). A bibliometric analysis of global Zika research. Travel Medicine and Infectious Disease, 14(1): 55-7. https://www.sciencedirect.com/science/article/pii/S1477893915001209?via%3Dihub.
Medjimurec MS, Mihelj E, Šćepanović D. (2018). The incidence and location of diastasis rectus abdominis during the childbearing year and puerperium at the Maternity Hospital Ljubljana. Zdravniški Vestnik, 87(6): 215-22. https://doi.org/10.6016/ZdravVestn.2450.
Mesquita NS, Rodrigues DP, Monte AS, Ferreira ALA, Manguinho CPC, Brandão JC. (2019). Percepções de puérperas acerca do cuidado de enfermagem recebido no pós-parto imediato. Revista de pesquisa: Cuidado é fundamental, 11(1), 160-6. http://www.seer.unirio.br/index.php/cuidadofundamental/article/view/6851/pdf.
Mørkved S, Bø K. (2014). Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. British Journal of Sports Medicine, 48(4): 299-310. http://dx.doi.org/10.1136/bjsports-2012-091758.
Mota P, Pascoal AG, Bo K. (2015). Diastasis recti abdominis in pregnancy and postpartum period. Risk factors, functional implications and resolution. Current Women's Health Reviews, 11(1): 59-67. DOI: 10.2174/157340481101150914201735.
Neels H, De Wachter S, Wyndaele JJ, Van Aggelpoel T, Vermandel A. (2018). Common errors made in attempt to contract the pelvic floor muscles in women early after delivery: a prospective observational study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 220(1): 113-7. https://doi.org/10.1016/j.ejogrb.2017.11.019.
Opala-Berdzik A, Dąbrowski S. (2009). Physiotherapy in diastasis of the rectus muscles of abdomen in women during pregnancy and postpartum. Physiotherapy, 17(4): 67-70. https://www.deepdyve.com/lp/de-gruyter/physiotherapy-in-diastasis-of-the-rectus-muscles-of-abdomen-in-women-ame8ReA7RL.
Pinto AVA, Schleder JC, Penteado C, Gallo RBS. (2015). Avaliação da mecânica respiratória em gestantes. Fisioterapia e Pesquisa, 22(4), 348-54. https://doi.org/10.590/1809-2950/13667922042015.
Pizzoferrato AC, Fauconnier A, Bader G, de Tayrac R, Fort J, Fritel X. (2016). Is prenatal urethral descent a risk factor for urinary incontinence during pregnancy and the postpartum period? International Urogynecology Journal, 27(7), 1003-11. https://link.springer.com/article/10.1007%2Fs00192-015-2918-z.
Rett MT, Almeida TV, Mendonça ACR, Santana JM, Ferreira APL, Araújo KCGM. (2014). Fatores materno-infantis associados à diástase dos músculos retos do abdome no puerpério imediato. Revista Brasileira de Saúde Materno Infantil, 14(1), 73-80. https://doi.org/10.1590/S1519-38292014000100007.
Rett MT, Bernardes NO, Santos AM, Oliveira MR, Andrade SC. (2008). Atendimento de puérperas pela fisioterapia em uma maternidade pública humanizada. Fisioterapia e Pesquisa, 15(4), 361-6. http://dx.doi.org/10.1590/S1809-29502008000400008.
Saboia DM, Bezerra KC, Neto JAV, Bezerra LRPS, Oriá MOB, Vasconcelos CTM. (2018). Eficácia das intervenções realizadas no pós-parto para prevenir incontinência urinária: revisão sistemática. Revista Brasileira de Enfermagem, 71(3): 1544-52. https://doi.org/10.1590/0034-7167-2017-0338.
Saleh MSM, Botla AMM, Elbehary NAM. (2019). Effect of core stability exercises on postpartum lumbopelvic pain: a randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation, 32(2), 205-13. DOI: 10.3233/BMR-181259.
Saligheh M, Hackett D, Boyce P, Cobley S. (2017). Can exercise or physical activity help improve postnatal depression and weight loss? A systematic review. Archives of Women’s Mental Health, 20(5): 595-611. DOI: 10.1007/s00737-017-0750-9.
Santana LS, Gallo RBS, Marcolin AC, Ferreira CHJ, Quintana SM. (2011). Utilização dos recursos fisioterapêuticos no puerpério: revisão da literatura. Feminina, 39(5), 245-50. http://files.bvs.br/upload/S/0100-7254/2011/v39n5/a2506.pdf.
Siddiqui AH, Tauheed N, Ahmad A, Mohsin Z. (2014). Função pulmonar em mulheres com gestação única ou gemelar avançada e sem complicações. Jornal Brasileiro de Pneumologia, 40(3), 244-9. https://doi.org/10.1590/S1806-37132014000300007.
Sousa L, Gomes-Sponholz FA, Nakano AM. (2014). Transcutaneous electrical nerve stimulation for the relief of post-partum uterine contraction pain during breast-feeding: a randomized clinical trial. The Journal of Obstetrics and Gynaecology Research, 40(5): 1317-23. https://doi.org/10.1111/jog.12345.
Teymuri Z, Hosseinifar M, Sirousi M. (2018). The effect of stabilization exercises on pain, disability, and pelvic floor muscle function in postpartum lumbopelvic pain: a randomized controlled trial. American Journal of Physical Medicine & Rehabilitation, 97(12), 885-91. https://journals.lww.com/ajpmr/Fulltext/2018/12000/The_Effect_of_Stabilization_Exercises_on_Pain,.5.aspx.
Theodorsen NM, Strand LI, Bø K. (2018). Effect of pelvic floor and transversus abdominis muscle contraction on inter-rectus distance in postpartum women: a cross-sectional experimental study. Physiotherapy, 105(3), 315-20. https://www.physiotherapyjournal.com/article/S0031-9406(18)30311-0/fulltext.
Torbé D, Stolarek A, Lubkowska A, Torbé A. (2016). Physical activity recommended in the early postpartum period. Pomeranian Journal of Life Sciences, 62(3): 53-6. https://www.researchgate.net/publication/317226858_Aktywnosc_fizyczna_zalecana_we_wczesnym_pologu/fulltext/59335fbe0f7e9beee7ad5aed/Aktywnosc-fizyczna-zalecana-we-wczesnym-pologu.pdf.
Unsgaard-Tøndel M, Vasseljen O, Woodhouse A, Mørkved S. (2016). Exercises for women with persistent pelvic and low back pain after pregnancy. Global Journal of Health Science, 8(9), 107-20. DOI: 10.5539/gjhs.v8n9p107.
Vanderkruik RC, Tunçalp Ö, Chou D, Say L. (2013). Framing maternal morbidity: WHO scoping exercise. BMC Pregnancy and Childbirth, 13(1), 1-7. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-13-213.
Werner LA, Dayan M. (2019). Diastasis recti abdominis-diagnosis, risk factors, effect on musculoskeletal function, framework for treatment and implications for the pelvic floor. Current Women's Health Reviews, 15(2): 86-101. DOI: 10.2174/1573404814666180222152952.
Witt AM, Bolman M, Kredit S, Vanic A. (2016). Therapeutic breast massage in lactation for the management of engorgement, plugged ducts, and mastitis. Journal of Human Lactation, 32(1), 123-31. https://journals.sagepub.com/doi/10.1177/0890334415619439?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed.
Wu YM, McInnes N, Leong Y. (2018). Pelvic floor muscle training versus watchful waiting and pelvic floor disorders in postpartum women: A systematic review and meta-analysis. Female Pelvic Medicine & Reconstructive Surgery, 24(2), 142-9. DOI: 10.1097/SPV.0000000000000513.
Yang S, Sang W, Feng J, Zhao H, Li X, Li P, Fan H, Tang Z, Gao L. (2017). The effect of rehabilitation exercises combined with direct vagina low voltage low frequency electric stimulation on pelvic nerve electrophysiology and tissue function in primiparous women: a randomised controlled trial. Journal of Clinical Nursing, 26(24): 4537-47. https://doi.org/10.1111/jocn.13790.
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