Esther Delgado-Pérez

Background: The levator ani muscle (LAM) plays a crucial role in maintaining pelvic floor function, providing support to pelvic organs and assisting in physiological processes such as micturition and defecation. Ultrasound imaging, particularly M-mode ultrasound, has been increasingly employed in the evaluation of pelvic floor muscle activity. Objectives: The goal of the present study was to assess the intra- and inter-rater reliability of M-mode ultrasound measurements of LAM thickness, muscle activation speed, and contraction time during a 5-s sustained pelvic floor contraction in asymptomatic women. Methods: Thirty-four healthy nulliparous women aged 18 to 25 were recruited for this cross-sectional study. Transabdominal M-mode ultrasound was used to measure the intra- and inter-rater reliability of LAM thickness during maximum pelvic floor contraction. Each participant performed three pelvic floor contractions, with measurements repeated twice. Results: Intra-rater reliability ranged from poor to good reliability for LAM thickness (ICC = 0.621–0.899), with similar results for pelvic rise time and contraction velocity. Inter-rater reliability was excellent for LAM thickness (ICC = 0.910) but only fair for pelvic rise time and contraction velocity (ICC = 0.673–0.647). Conclusions: M-mode ultrasound imaging demonstrates excellent inter-rater reliability for LAM thickness measurement and fair intra-rater reliability for other functional variables. This technique appears to be a promising method for evaluating pelvic floor muscle activity.

Smart furniture (smart cities) can provide publicity, mobility services and local government communication, among many other services; however, its use for improving the quality of life of the elderly (extended IP-spaces concept) can be further researched. This paper describes the first step in a collaborative design of a smart city platform based on this concept. This design requires a layered design, as it includes architectonic, artistic, technological and social aspects. Participatory design (PD) and participatory action research (PAR) methodologies were selected to include the elderly in the design to ensure the acceptance and usability of the system. During this specific design process, three groups of elderly people from three geographic points of Spain were recruited. PD was applied to capture the users’ preferences and general specifications regarding the architectonic aspect of the project, while PAR was used to capture these groups’ quality-of-life needs, determine the initial acceptance of the project and define the initial activities to be realized for mitigating the detected needs. The application of these qualitative methodologies should produce a user-centric, valuable but local (specific) design. As more groups and towns will be involved, the new local designs will build a bigger set of validated solutions that potentially could be customized and reused for other contexts.

Background: Lipedema is an adipose tissue disorder in women, with an abnormal fat deposition in lower limbs and occasionally upper limbs. The condition is characterized by pain, bruising, heaviness, and mobility impairment. Objectives: This study aims to evaluate the effects of a modified Complete Decongestive Therapy protocol using the Godoy Method in the postoperative period following lipedema surgery. Methods: In total, 293 participants who underwent liposuction for lipedema were studied. The postoperative physiotherapy protocol included Godoy cervical stimuli, Manual Lymphatic Drainage based on Godoy maneuvers, mechanical lymphatic drainage with RAGodoy^®, compression with bandages, skin care, and therapeutic education. Results: This study found that the number of physiotherapy sessions significantly reduced pain (p = 0.000) and other complications (p = 0.007) and increased mobility (p = 0.003). The number of physiotherapy sessions showed significant differences in pain intensity at 90 days post-treatment (p = 0.000). In total, 47.24% of the participants became functionally independent on the third day of the physiotherapy intervention (p = 0.003). A total of 40.96% of the participants developed some complications, although a relationship between inadequate compression and the occurrence of complications was also found in 36.52% of patients. Conclusions: The success of surgical treatment for lipedema not only depends on the surgery itself but also on the proper management of the patient in the perioperative period to minimize complications and prevent recurrence. The Complete Decongestive Therapy protocol modified with the Godoy Method showed effects on pain reduction, mobility increase, edema reabsorption, and prevention of complications, consequently enhancing functionality and quality of life for patients undergoing lipedema surgery.

This study aimed to determine the strategies used by women to adapt to the changes that affect the first sexual relations after childbirth. A qualitative study with a phenomenological approach used three data collection techniques (in-depth interviews, discussion groups, and online forums). Thirty-six women in the first six months postpartum participated in the study, from physiotherapy centers with maternal child specialties in several locations in Spain. Women with different types of delivery, presence or absence of perineal trauma during delivery, previous deliveries, and different types of breastfeeding were included. Among the strategies, closeness support and understanding were the ones that women used to adjust to the new situation, in order to improve the couple’s relationship, intimacy, and cope with the significant changes that appear in the first six months postpartum. Changes and adaptations in sexual practices become a tool for coping with a new sexuality, especially if it is affected by the presence of pain or discomfort associated with physical changes. Personal time facilitates emotional management and improvement of emotional changes related to the demands of motherhood. Accepting the changes that motherhood brings is critical to dealing with the new situation. Strategies used by postpartum women focus on acceptance, self-care, partner, couple time, personal time, and adapting encounters. The findings of this study are of interest to health professionals as they provide insight into how women cope with the changes that appear in the first six months postpartum. In this way, the findings will be able to transmit to couples the alternatives they can adopt before the resumption of sexual relations to improve satisfaction both as a couple and in terms of sexuality after childbirth.

The aim of this study was to explore the experience of women who take care of their children in postpartum and who desire to be understood by society, with no judgements. For this purpose, a qualitative methodology was followed. In-depth interviews, discussion groups, and an online forum were used for data collection. The participants were Spanish women that had given birth in the past 6 months, and their partners. Healthcare specialists with experience in the topic were also included. Results showed three main categories: lack of priority, self-demand, and self-esteem changes. As a conclusion, the concept of motherhood needs to be redefined, as women feel that they are living under the pressure of being a “perfect mother”. It is important that mothers allow themselves to fail in reaching the imposed requirements. Simple acceptance of motherhood boundaries could help in this transition.