Effect of adding pelvic floor muscle training to weight loss intervention on urinary incontinence in overweight women: A randomized controlled trial

ObjectiveOur objective was to study the effect of the association of weight loss intervention and pelvic floor muscle training (PFMT) on unirary incontinence (UI) in obese women.MethodsThis prospective study included 107 obese women with urinary incontinence (UI) randomized into three groups: G1 including women who underwent a training program with a low calorie diet, G2 women who underwent the same training associated to a PFMT and G3 women without any therapeutic intervention. An evaluation was realised a week before the beginning and after 12 months.ResultsA reduction of the BMI (body mass index) was noted in G1 and G2 (P<0.001). Sixty-six percent of women in G1 and 85.3% of women in G2 reported that their condition improved. The score of PFM strength was significantly improved only in G2 (P<0.001). Only in the two first group, we noted a significant reduction in the number of voiding and of leakages per day (P<0.001), a significant amelioration in the 24-hour pad test (P<0.001) and a significant improvement of the Urinary Disability Measure (UHM) and the score of quality of life (P<0.001). The improvement of all these parameters was more important in G2 (P<0.001).DiscussionThere are studies that report the effect of either weight loss intervention or PFMT for treating female UI [1,2]. However, there is no study that reveals whether or not there were additional effects of adding weight loss intervention to PFMT for UI in obese women. This work shows that the best management for UI in obese women must include weight loss intervention and PFMT with making women aware of their floor pelvic muscles. However, the limited nature of follow-up beyond the end of treatment means that the long-term outcomes of use of PFMT or weight loss intervention remain uncertain

Translation into Arabic and validation of the ASES index in assessment of shoulder disabilities

AbstractObjectiveTo translate into Arabic and validate the “American Shoulder and Elbow Surgeons Evaluation Form” (ASES) for use in a Tunisian population presenting with periarticular pathologies of the shoulder.BackgroundNo functional index assessing the functional capacities of the shoulder is presently available in Arabic.Patients and methodsThe translation was achieved by means of forward/backward translation. Adaptations were carried out subsequent to a preliminary test involving 15 persons. Patients with periarticular shoulder disabilities were included. Clinical measurements evaluated pain and functional disability by means of the visual analogue scale (VAS). Interrater concordance (repeatability) was assessed using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct validity (convergent and discriminant validity) was investigated using the Spearman rank correlation coefficient and a factorial analysis followed by orthogonal rotation. The internal consistency of each factor was graded in terms of the Cronbach alpha coefficient.ResultsEighty (80) patients were included in the study. Interrater concordance was excellent (ICC=0.96). The Bland and Altman method showed a low-variability mean difference. Correlations of the index score with the pain VAS (r=−0.49) and functional disability (r=−0.58) suggested satisfactory convergent validity, and our index likewise showed good discriminant validity. Factorial analysis led to the extraction of two factors with a cumulative variance rate of 92.6% that could not be explained.ConclusionTranslated into Arabic, the ASES index was found to possess high metrological qualities. While the index has been satisfactorily validated with regard to a Tunisian population, additional studies are needed to verify its applicability to other Arab populations

Relationship between muscular strength, gait and postural parameters in multiple sclerosis

AbstractObjectiveTo evaluate muscle strength, balance control and gait capacity in patients with multiple sclerosis (MS) and to study the correlations between these parameters.Patients and methodsTwenty MS patients were evaluated in terms of knee muscle strength, gait and balance parameters. These evaluations were performed using an isokinetic dynamometer (the Cybex II®), a Bessou gait analyzer and a Satel® force platform, respectively. The patients’ results were compared with those of a healthy control group.ResultsHamstring and quadriceps peak torque values were lower in the MS group than in the control group. The sway area was greater in the MS group under eyes-open and eyes-closed conditions. The MS patients displayed lower gait speed, cadence and stride length. Hamstring and quadriceps strength values were significantly correlated with posture and gait parameters.ConclusionThe present study revealed the value of an overall evaluation of knee muscle strength, gait and posture in MS patients