Impact of verbal instructions on pelvic floor contraction in the immediate postpartum

Authors

DOI:

https://doi.org/10.1590/fm.2022.356010

Abstract

Introduction: Pregnancy predisposes the emergence of pelvic floor dysfunctions (PFD), postpartum being the opportune moment to assess these muscles. Objective: To investigate the effect of instructions and verbal feedback on the contraction capacity of pelvic floor muscles (PFM) in postpartum women. Methods: Quasi-experimental study with 109 women in the immediate vaginal postpartum at a reference maternity hospital in Fortaleza, Ceará state, Brazil. PFM were visually inspected using the visual contraction scale (0 = no visible contraction; 1 = weak visible contraction; 2 = visible contraction with perineal elevation), in addition to observing the use of accessory muscles and movements. Assessments occurred in consecutive moments: 1 – PFM contraction at a verbal command; 2 – contraction after instructions on structure, function and correct contraction; and 3 – contraction after feedback on the use of accessory muscles and reinforcement of correct contraction. Cochran’s Q test and a 5% significance level were used to compare the outcomes between different moments. Results: At the first assessment, 15.6% of the postpartum women did not exhibit visible PFM contraction (grade 0). Of these, 70.5% changed their contraction grade after instructions and feedback. At the end, 45.9% of women correctly contracted their PFM with perineal elevation (grade 2) (p < 000.1). The use of accessory muscles (abductors, abdominals and gluteal) declined after instructions and feedback (p < 000.1). Perineal trauma, forceps delivery, previous information and fear of feeling pain were not associated with contraction grade. Conclusion: Instructions and verbal feedback are useful tools for correct PMF contraction in the immediate postpartum.

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Author Biographies

Andressa Soares de Azevedo, Universidade Federal do Ceará (UFC)

Programa de Mestrado Profissional em Saúde da Mulher e da Criança - Departamento de Saúde da Mulher, da Criança e do Adolescente.

Isabella Parente Ribeiro Frota, Maternidade Escola Assis Chateaubriand (MEAC), Universidade Federal do Ceará (UFC)

Unidade de Reabilitação, Serviço de Fisioterapia Pélvica

Amene Cidrão Lima, Maternidade Escola Assis Chateaubriand (MEAC), Universidade Federal do Ceará (UFC)

Unidade de Reabilitação, Serviço de Fisioterapia Pélvica

Glaucia Nunes Diniz de Oliveira, Universidade Federal do Ceará (UFC)

Projeto de Extensão Fisioterapia na Saúde da Mulher do Departamento de Fisioterapia

Mayle Andrade Moreira, Universidade Federal do Ceará (UFC)

Projeto de Extensão Fisioterapia na Saúde da Mulher do Departamento de Fisioterapia. Docente do Departamento de Fisioterapia.

Simony Lira do Nascimento, Universidade Federal do Ceará (UFC)

Projeto de Extensão Fisioterapia na Saúde da Mulher do Departamento de Fisioterapia. Docente do Departamento de Fisioterapia.

Published

2022-09-16