Relação entre histórico uroginecológico e obstétrico e desempenho físico de membros inferiores em mulheres de meia-idade e idosas: um estudo transversal

Abstract

Introduction: The decline in physical performance of the lower limbs is one of the main factors responsible for the increase in falls and disabilities in the elderly population, being among the associated factors, the urogynecological and obstetric history. Previous studies have shown that variables such as early maternal age, parity, and menopause status are associated with the physical performance assessed by the Short Physical Performance Battery (SPPB). However, studies are needed to verify the relationships between other variables of the urogynecological and obstetric history and the physical performance of lower limbs evaluated SPPB, in addition to the strength of knee flexors and extensors. Objective: To analyze the relationship between variables of urogynecological and obstetric history and the physical performance of lower limbs in middle-aged and elderly women. Methods: Cross-sectional study, carried out with women between 40 and 80 years of age, from the municipality of Santa Cruz and Parnamirim-RN. Participants were assessed for socioeconomic and demographic aspects, clinical evaluation (BMI, comorbidities, and physical activity), urogynecological and obstetric history (age at menarche, early menarche, number of pregnancies, number of deliveries, age of first pregnancy, age of last pregnancy, first premature child, use of hormone therapy, hysterectomy, urinary incontinence, and pelvic organ prolapse) and physical performance of lower limbs (SPPB, knee flexor, and extensor strength). The normality of the data was verified by the Kolmogorov-Smirnov test. To evaluate the relationships between the independent variables and the dependent variables, Student's T-tests, ANOVA, and Pearson's correlation were used. Linear regression models were analyzed to observe the relationship between variables of urogynecological and obstetric history and the physical performance of lower limbs, adjusted by covariates. The data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 22.0. Results: 581 women participated in the study, with a mean age of 54.8 ± 9.4 years. The only variable in the urogynecological and obstetric history that was associated with the physical performance of the lower limbs was the number of deliveries for the knee extension variables (β = -0.41; CI = -0.65 - 0.22; p = 0.009 ) and SPPB (β = - 0.08; CI = -0.11 - 0.05; p = 0.002). Conclusion: The number of deliveries was the only variable in the urogynecological and obstetric history associated with the worse physical performance of the lower limbs, after adjustments for covariates. Older age, lower family income, stable union, and not performing physical activity remained associated with worse physical performance in the final model. Thus, health and rehabilitation strategies are needed to focus on preventing pathophysiological mechanisms that trigger the decline in physical performance in women, particularly in women with a high number of deliveries.