Browsing by Author "Mena, Maria"
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Item Lumbopelvic pain, urinary incontinence and quality of life in pregnant women in a low income and social risk chilean population.(Elsevier, 2015) Mena, Maria; Roa, Sonia; Besomi, Manuela; Leppe, JaimeBackground: Urinary incontinence (UI) and lumbopelvic pain (LPP) are musculoskeletal problems prevalents during pregnancy. These disorders are associated with quality of life disturbance. In Chile, the measures of those pathologies trough the development of pregnancy have not been studied in low incomes and social risk populations. Purpose: To determine the need of musculoskeletal health care in pregnant women treated in a primary care public center with low incomes and social risk population in Santiago, Chile. The prevalence of lumbopelvic pain and urinary incontinence, and the quality of life is one way of determining that need. Methods: It was made a follow-up of a cohort group of 112 women in a primary health care community center, between years 2012 and 2014. Pregnant women between 18 and 40 years old and coursing health pregnancy with one fetus, were eligible. The recruitment was made in the first pregnancy control, after the informed consent process was developed. They answered a questionnaire which included questions about presence of LPP and UI and quality of life, who was measured with EQ-5D questionnaire. Three measures was made to each subject, one in each trimester. Results: From a total of 112 women with 3 performed measures, a 90,1% begin the pregnancy with LPP. The movement or transfer were the most affected dimensions. During the second and third trimester, the prevalences of LPP were 89% and 91% respectively. In the first trimester of pregnancy, they reported a 27,9% of UI, this percentage was increased until a 51,4% of prevalence in the second trimester, and presented a value of 48,2% in third trimester. Related to quality of life, according to EQ-5D measures, the prevalences in the first, second and third trimester were 60%, 80% y 70% respectively, and there was not statistically significant difference between the first and third trimester. The dimension of quality of life that reported more problem was pain. Conclusion(s): In this population, lumbopelvic pain prevalence is higher than those values reported in literature since the first stage of pregnancy, and it keeps high. The urinary incontinence prevalence also experimented a raise through pregnancy. Despite of these prevalences, quality of life in pregnants of this group is similar to the corresponding population, being higher in the second trimester, which is consisting with the biggest prevalence of UI and with a 88,9% of prevalence of LPP. It confirms the need to develop a program to educate and give treatment to musculoskeletal dysfunctions of pregnant women. Implications: Despite that lumbopelvic pain prevalences are higher than usually reported in pregnancy, specifically at the beginning of this one, it does not seem to lead to a poorer quality of life in these women. Adult Chilean women also have high prevalence of musculoskeletal symptoms, according to the National Health Survey 2009–2010, and they do not recognize this as a problem that affects their quality of life. Because of this, education for knowledge about the effectiveness of treatments for musculoskeletal problems, such as physical therapy interventions, should be the subject of future research and interventions.Item Measuring physical activity and sedentary behaviors in pregnancy: a comparison of accelerometry and questionnaires(Elsevier, 2015) Leppe, Jaime; Aguilar, Nicolas; Mena, Maria; Besomi, Manuela; Roa, SoniaBackground: Physical activity (PA) during pregnancy may reduce the risk of maternal and fetal disorders. Few studies have validated questionnaires for use during pregnancy, a time characterized by different patterns of activity than nonpregnancy. Purpose: This study compares PA and Sedentary Behaviors (SB) using two questionnaire methods with objectively recorded physical activity using accelerometry in primary health care, in a population with low income and low educational level. Methods: The design was a longitudinal observational study of SB, PA intensity, type and duration using subjective and objective measurement methods. The women between 18 and 40 years old were recruited at primary care health. The Global Physical Activity Questionnaire (GPAQ) and Pregnancy Physical Activity Questionnaire (PPAQ) were used to measure PA and SB. For objectives measurement, the women wore accelerometer (ActiGraph GT3X plus) for at least 7 days. The questionnaires (GPAQ-PPAQ) and accelerometry was measured in three times: first trimester between 8 and 10 weeks, second between 25 and 29 weeks and third trimester between 34 and 38 weeks gestation. Results: One hundred twelve women participated. The median (P25–P75) for Age = 26 (22–31) years, level of education = 12 (10–12) years, BMI = 27.4 (24.3–31.7). The 11% reported being married, and 63.9% have not work. PA by accelerometry and GPAQ: •According GPAQ by trimesters was median: 1◦ = 162.8 min/day, 2◦ = 107.1 min/day and 3◦ = 117.9 min/day. •According accelerometry PA level of moderate or vigorous intensity was median = 0 in all trimesters. SB by accelerometry and GPAQ: • According GPAQ by trimesters was median: 1◦= 180 min/day, 2◦= 240 min/day and 3◦= 240 min/day. • According accelerometry by trimesters was median: 1◦= 604 min/day, 2◦= 594 min/day and 3◦= 575 min/day. •The correlation between GPAQ and accelerometry was Spearman’s rho = 0.4, p < 0.01. PA and SB according PPAQ: •According PPAQ, energy expenditure associated with PA in each trimesters was median: 1 ◦ = 217 METs/hour/week, 2◦= 181 METs/hour/week and 3◦= 130 METs/hour/week. •The correlation between energy expenditure PPAQ and accelerometry was Spearman’s rho = 0.3 p= 0.03 • For SB, the correlation between PPAQ and accelerometry was Spearman’s rho = 0.3, p= 0.02. The decrease in PA according GPAQ and PPAQ during pregnancy is statistically significant p < 0.05. Conclusion(s): The objective measurement of PA shows that this group does not adhere to the recommendations PA level according American College of Obstetricians and Gynecologists or World Health Organization. Pregnant women overestimated the time spent in physical activities and underestimated the time spent in sedentary behaviours. Objective methods should be used where possible in studies measuring physical activity in pregnancy. Implications: This study indicates a need for more information and motivation for moderate exercise throughout pregnancy in this group. The physical therapist is the professional who can and should do health promotion in this area.Item Nivel de actividad física según GPAQ en mujeres embarazadas y postparto que asisten a un centro de salud familiar(Sociedad Chilena de Obstetricia y Ginecología, 2013) Leppe, Jaime; Besomi, Manuela; Olsen, Catalina; Mena, Maria; Roa, SoniaBackground: During pregnancy and postpartum, women decrease physical activity (PA) levels despite the health benefits reported in the literature for women and the fetus. Aims: To determine PA levels and sedentary behaviour in women during pregnancy and postpartum. Methods: Pregnant and postpartum women between 18 and 40 years old attending to primary care center participated. Sedentary behaviour and PA were measured using the Global Physical Activity Questionnaire (GPAQ). Results: Information was collected from 47 pregnant and 12 postpartum women. Age was P50=25 (range: 18-40 years). 61% were overweight. Daily PA time was P50=154 (range: 0-960 min/day) for pregnant women and P50=190 (range: 24-411 min/day) during postpartum. Leisure time PA was P50=0 (range: 0-540 min/day) for pregnant women and P50=3 (range: 0-86 min/day) during postpartum. Sedentary behaviour was P50=180 min/day (range: 0-720 min/day) for all women. According to WHO criteria, only 20.3% of women are physically active, adjusting by BMI and educational level the reported PA in GPAQ. There was no association between the variables age, nutritional status, educational level, family income and reported level of PA. Conclusion: Leisure time PA could be susceptible to PA promotion interventions. The reported level of PA is higher than those from similar studies in other countries. Validation studies are needed to determine possible overestimation of the results due to measurement bias.Item Perception of musculoskeletal health and knowledge about physical activity among pregnant women with low income and low educational level.(Elsevier, 2015) Roa, Sonia; Mena, Maria; Besomi, Manuela; Leppe, JaimeBackground: Urinary incontinence (UI) and lumbopelvic pain (LPP) are prevalent musculoskeletal problems during pregnancy, yet few women consult for treatment. Additionally women report low levels of physical activity (PA) neglecting their musculoskeletal health. In Chile, the vulnerable population has limited information about musculoskeletal health. Purpose: To determine the perception of “normality” of the most common musculoskeletal disorders in pregnancy and knowledge about physical activity in a population of vulnerable women attending a primary health care center. Methods: It was made a follow-up of a cohort group of 112 pregnant women in a primary health care center between years 2012–2014. It was made a follow-up of a cohort group of 112 pregnant women in a primary health care center between years 2012–2014. Pregnant women between 18 and 40 years old and coursing healthy pregnancy with one fetus, were eligible. The recruitment was made in the first pregnancy control, after the informed consent process was developed. They answered a survey which included questions about presence/absence of LPP and UI, perception of “normality” about LPP and UI, and their knowledge about recommended dosis of PA during pregnancy. Three measures were made to each subject, one in each trimester. Health information was extracted from the clinical record. Results: From a total of 112 women with 3 performed measures, on average 81.5% of women considered “normal” the LPP, (72.1% 1st trimester, 81.7% in the 2nd and 90.7% in 3nd). The UI was considered “normal” on average 57.1%. The prevalence of LPP was 92% on average and for UI was 42,5%. The recommended dose for PA more reported was “30 minutes, 3 times per week”, the words more used to identify intensity were “moderate”, “medium” (50%), Other answers were “light”, “soft” and “I don’t know”. On average 70% of the studied population had overweight. Conclusion(s): Almost all pregnant women considered “normal” for the presence of LPP during pregnancy and nearly half feel “normal” to have urine leakage during pregnancy. The perception of “normality” of both conditions was increased by the third trimester. Both conditions correspond to common pathological disorders in pregnancy, however, people confuse the term “common” to “normal”. LPP and UI were prevalent in this group. Women did not clear the recommended amount of physical activity during pregnancy and they were overweight. Implications: This study identifies the need of planning effective education strategies for the population of pregnant women for the prevention and treatment of musculoskeletal disorders as a means of promoting self-care, mainly clarifying the difference between conditions that are “common” but not “normal”. The physical therapist is the professional of health team who should educate to the population about musculoskeletal health issues and promote his clinical role.