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Introduction The International Continence Society (ICS) determines that the pelvic floor muscles training (PFMT) is the first-choice treatment of urinary symptoms in women. Objective The aim of this study was to systematize randomized controlled clinical trials that address the effects of PFMT in the treatment of urinary symptoms in older women using objective outcome measures. Method Systematic review search was performed eletronic the following databases: Medline, Pubmed, Lilacs, PEDro and manual research conducted in the references of the studies. Were considered eligible women aged over 60 years who performed PFMT in isolation, without the involvement of another technique. The PFMT performed in clinic or at home, with or without the supervision of a therapist and with or without the use of biofeedback as an adjunct. Considered as outcome measures urodynamic studies, voiding diary that assesses daytime urinary frequency, nocturnal urinary frequency, urinary incontinence and exchange absorbent, and, finally, the absorbent test that quantifies loss urinary grams. The assessment of methodological quality of the studies was conducted by PEDro scale. Results Three studies were reviewed in full. Only one trial was rated high methodological quality. There was significant improvement in urinary symptoms after treatment proposed in the three selected studies. Conclusion Considering the studies available so far are weak the evidence for the use of PFMT in the treatment of urinary symptoms in elderly women.

DEDICATÓRIAO doutorado é um curso em que podemos exercer uma contribuição a ciência.Ter como inspiração alguns dos pesquisadores mais lembrados pela história da osteopatia tal como o Denslow, DO, PhD, que pesquisava a fisiologia humana e tentava explicar por meio da luz da ciência o que acontecia aos pacientes que sofriam intervenção osteopática é de fato algo que me fez seguir adiante com as idéias apresentadas nessa tese. Osteopatas clínicos que fazem o seu trabalho no dia a dia tentando amenizar o sofrimento das pessoas também são importantes como inspiração desse trabalho. Paulo Roberto Dobruski (Curitiba -PR), Carlos Augusto Pimpão Valente (Brasília -DF) e Luis Rivas Cano (Espanha) são os nomes que escolhi para representar todos esses profissionais que são a via final do nosso trabalho em ciência. Em especial e, por fim, ao meu orientador Prof. Gerson Cipriano Júnior.Primeiramente por acreditar nas minhas idéias, que, para quem não é osteopata, podem soar estranhas. Por passar o ideal de um trabalho em grupo de pesquisa, poder proporcionar ao longo do curso formação de pesquisa: como procurar, como interpretar, como tabular, planilhar, interpretar e escrever, deixando da forma mais simples possível. Por ajudar a proporcionar os recursos de pesquisa e nos estimular a essa busca. Ao longo desses 4 anos de curso eu falava que queria aprender começando do zero e tentar absorver o máximo possível, sem tentar queimar etapas, e ele com muito zelo, atenção, carinho e paciência se dedicou a cada passo. Espero poder sido VI um bom aluno da mesma maneira como ele foi um bom orientador. Results: Gap 1: FMD incresead (pre x time course 14% ± 2.29 to 23.5% ± 6.87 p = 0.027), absolute difference (pre x time course 0, 6 mm ± 1.07 ± 0.29 for 0.159 p = 0.03) and diameter of peak (pre x time course 4, 9 mm ± 0.74 to 5.67 ± 0.76 p = 0.003 and post x time course 5 mm ± 0.58 to 5.67 ± 0.76 p = 0.02) also. However, vagal autonomic function indices increased immediately after the technique (RMSSD, SDNN and SD1) and after 10 minutes of follow-up increased vagal maintenance in addition to increased sympathetic (LF) index. 2 Gap: RSMA: Manipulation promotes increased LF norm and LF/HF. Intra articular mobilization improves skin conductance (during the application). No change of the parasympathetic system and HR after the manipulation. Amazingly, after the execution of the intra articular mobilization, skin conductance also did not change. Gap 3: RCT: Without relevant changes in BP and HR after cervical OMT in any of the groups immediately or after 24 hours. Conclusion: Gap 1: the OMT was able to modulate the vascular and Autonomic system in patients with heart failure. Amazingly, the vascular adjustments seem to occur immediately after the application of the technique, independent of the sympathetic modulation. 2 gap: SRMA: MTS increase sympathetic ANS, but does not change the parasympathetic or HR. Gap 3: RCT: The cervical OMT does not produce immediate change and 24 hours in BP and HR significant showing be safe on cardiovascular ...

Background: A therapeutic recommendation for restoring function in individuals with chronic low back pain (CLBP) is manual therapy through manipulative spinal or muscle energy techniques.Objectives: To compare the effectiveness of two osteopathic manipulative techniques on clinical low back symptoms and trunk neuromuscular postural control in male workers with CLBP.Method: Ten male workers with CLBP were randomly allocated to two groups: high-velocity low-amplitude (HVLA) manipulation or muscle energy techniques (MET). Each group received one therapy per week for both techniques during 7 weeks of treatment. Pain and function were measured by using the Numeric Pain-Rating Scale, the McGill Pain Questionnaire and the Roland Morris Disability Questionnaire. The lumbar flexibility was assessed by Modified Schober Test. Electromyography (EMG) and force platform measurements were used for evaluation of trunk muscular activation and postural balance, respectively at three different times: baseline, post intervention, and 15 days later.Results: Both techniques were effective (p 0.01) in reducing pain with large clinical differences (-1.8 to -2.8) across immediate and after 15 days. However, no significant effect between groups and times was found for other variables, namely neuromuscular activation and postural balance measures.Conclusion: Both techniques (HVLA thrust manipulation and MET) were effective in reducing back pain immediately and 15 days later. Neither technique changed the trunk neuromuscular activation patterns nor postural balance in male workers with LBP.Clinical implications: These results may facilitate clinical decision-making for CLBP management in physiotherapy programs.

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