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Biomedical subjects

M C Dougherty

Publications and source records attributed to M C Dougherty.

At least 19 recordsLinked to original sources

Pelvic muscle exercise effect on pelvic muscle performance in women.

The aim of this study was to compare pelvic muscle (PM) characteristics (strength, endurance and contractability) before and after 12 weeks of pelvic muscle exercises in two groups of older women: the first composed of women with genuine stress incontinence, and the second made up of women with no symptoms of urinary incontinence or pelvic organ prolapse. This research also investigated the extent to which PM pressure and health-related characteristics could help discriminate between women with and without a clinical sign of PM dysfunction. Within a framework of skeletal muscle fitness, outcome measures were defined and compared. There was no significant difference in the baseline (P = 0.09) and post-PME (P = 0.63) strength, endurance and contractability of the two groups of women. The two groups did differ significantly on change scores (P = 0.05) following PME. A greater improvement in strength for women without a clinical sign of dysfunction was demonstrated. There was a probability of 91% that those with a history of gynecological surgery belonged to the group of women with SUI.

Adult↗

Dietary caffeine, fluid intake and urinary incontinence in older rural women.

Forty-one women completed the first phase (self-monitoring) of the Behavioral Management for Continence (BMC) intervention, while working with a nurse during home visits to reduce involuntary urine loss as part of the parent study involving older, rural women living at home. A decrease in dietary caffeine intake and an increase in fluid intake were most frequently recommended. The relationship between a decrease in the amount of dietary caffeine consumed and fewer daytime episodes of involuntary urine loss approached significance -P = 0.0744- whereas an increase in the average amount of fluid intake was significantly related to an increase in the average volume of urine voided -P = 0.0479- and not to involuntary urine loss.

Aged↗

Continence for women: evidence-based practice.

Approximately 20% of women ages 25-64 years experience urinary incontinence. The symptoms increase during perimenopause, when 31% of women report that they experience incontinent episodes at least once per month. Bladder training and pelvic muscle exercise are the recommended initial treatment and can be taught effectively in the ambulatory care setting. Bladder training enables women to accommodate greater volumes of urine and extend between-voiding intervals. Pelvic muscle exercise increases muscle strength and reduces unwanted urine leakage. Accumulated research results provide evidence-based guidelines for nursing practice. The Association of Women's Health, Obstetric and Neonatal Nurses has identified continence for women as the focus of its third research utilization project. This article presents the rationale, evidence base, and educational strategies compiled by the Research Utilization 3 Nurse Scientist Team. Nurses can enable women to incorporate these noninvasive techniques into self-care.

Adult↗

Current status of research on pelvic muscle strengthening techniques.

In the past 15 years, research on the effect of pelvic muscle exercise on urinary stress incontinence has contributed substantially to the understanding of the function of the pelvic muscles and the role of pelvic muscle exercise in management of stress urinary incontinence. This literature review addresses pelvic muscle function, pelvic muscle exercise, pelvic muscle exercise training protocols and training aids, changes that result from pelvic muscle exercise, and long-term outcomes of pelvic muscle exercise. Emphasis is placed on results or research that may be used by the clinician with women who experience stress urinary incontinence.

Exercise Therapy↗

Differences by race in the decline of health over time.

Previous research on race differences in health, we believe, has failed to take into account the initial state of health of the respondents. Other research has demonstrated that elders in poor health are more likely to experience a change in their health over time. It is unclear if the greater probability of decline in health observed among African Americans is a result of being more likely to begin such observations in health states that are worse than those for Whites. This investigation examines declines in health over a 30-month period in a sample of African American and White elders who began the study in similar "good health." Findings support the supposition that African Americans are more likely to report a decline in their health, regardless of the health measure used. Differences by race in the decline of health appear to be a consequence of economic and educational discrepancies between the two groups.

Black or African American↗

Race differences in the health of elders who live alone.

This investigation was initiated to determine whether older African Americans who live alone are in poorer health than their White counterparts who live under the same circumstances. Data on 5 measures of health were collected in telephone interviews with a stratified random sample of community-dwelling elders (n = 1,189). Analysis of weighted data indicate that there were fewer differences in health by race among older persons who lived alone compared to elders who lived with others. Where racial differences in health did exist among older adults who lived alone, the differences could only sometimes be accounted for by population composition factors that are known to influence health.

Activities of Daily Living↗

Behavioral management for bladder control: response in selected rural residential care homes.

Urinary incontinence is a problem for elders in many settings, including rural residential care homes (RCHs). Behavioral techniques for the management of urinary incontinence have been successful with community-dwelling and nursing home populations. A study was undertaken to evaluate the feasibility of implementing bladder diaries and bladder training to assist RCH residents with bladder control. These techniques were found not to be successful in selected rural RCHs. The characteristics of rural RCHs are explored, and the impediments and incentives to the use of behavioral management techniques for urinary incontinence in these settings are examined.

Aged↗

Validation of surface EMG as a measure of intravaginal and intra-abdominal activity: implications for biofeedback-assisted Kegel exercises.

This study validates surface EMG as a measure of pelvic muscle and abdominal activity by showing its high correlation to internal pressure data. Using standardized scores, between-subjects correlation of perineal EMG and intravaginal pressure was r = .75, and the correlation of abdominal EMG and intra-abdominal pressure was r = .72. Discriminant validity was also demonstrated by showing low correlation between standardized abdominal and perineal EMG measurements (r = .10). A repeated measures multivariate analysis of variance demonstrated that visual and auditory biofeedback of EMG during pelvic floor contractions increases intravaginal pressure when compared with trials without biofeedback. Potential benefits of fabric electrodes include reduced invasiveness and risk and the ease with which patients can utilize this technology for home practice.

Abdominal Muscles↗

Stress urinary incontinence: effect of pelvic muscle exercise.

Twenty women with stress urinary incontinence diagnosed by urodynamic testing participated in a 6-week pelvic muscle exercise program. The aim of the study was to evaluate the effectiveness of the exercise program, with or without an intravaginal balloon, on urinary leakage as determined by a 30-minute and a 24-hour pad test. Relative strength of the pelvic muscles was evaluated using an intravaginal device that measures the pressure generated during a muscle contraction. After completion of the exercise program, 18 of the 20 subjects had an increase in strength of the pelvic floor muscles, as demonstrated by increased intravaginal pressure or a decrease in urinary loss on the 24-hour pad test. The use of an intravaginal balloon did not improve performance of the pelvic muscles or decrease urinary loss as compared with the subjects who exercised without an intravaginal balloon. Twelve months after the completion of the exercise program, 19 of the participants responded to a questionnaire about their urinary loss and performance of pelvic muscle exercises. None of the subjects stated that her urinary loss was worse, three had undergone surgical intervention, and ten had not continued to exercise. Seven subjects still exercised, with subjective improvement of urinary loss. It appears that pelvic muscle exercises may be successful in improving the condition of stress urinary incontinence; however, half of the subjects did not continue to exercise independently.

Adult↗

Custom-made vaginal balloons for strengthening circumvaginal musculature.

A technique for making individualized silicone rubber intravaginal balloons is described. The method entails investing alginate vaginal impressions in silicone rubber and casting a resin model which is then dipped repeatedly in a Silastic Dispersion (Dow Corning, Q7-2213). The range of forces developed by circumvaginal muscles during maximum contractions was determined to be 0.5-4 lbs. Pressure-volume relationships of the balloons showed that the pressure of filling fluid was an accurate replica of the mean pressure in the vagina.

Female↗

Lipids and lipoproteins in women after oophorectomy and the response to oestrogen therapy.

The short-term effects of different types and doses of oestrogen on serum lipids and lipoproteins were studied in 35 oophorectomized women. After 3 months treatment, serum cholesterol levels were unaffected by 1 and 2 mg of micronized 17 beta-oestradiol or 0.625 and 1.25 mg of conjugated equine oestrogens. Triglyceride levels were significantly elevated after treatment with 1.25 mg of conjugated oestrogens. A trend towards a higher relative proportion of high-density lipoproteins and a lower relative proportion of low-density lipoproteins was observed for all four oestrogen regimens, however, statistical significance was not achieved. The proportion of very-low-density lipoprotein was unaffected by oestrogen treatment. The age of the oophorectomized women was found to have no effect on either the direction or magnitude of the lipid or lipoprotein responses to oestrogen. Using FSH depression as an index, 1.25 mg of conjugated oestrogens was found to be the most potent of the four oestrogen regimens tested. Therefore, with respect to lipid balance, little additional clinical benefit is achieved by using a more potent regimen and the risk of adverse side effects may be increased.

Adult↗

Oestrogen--progestin therapy and the lipid balance of post-menopausal women.

The lipid and lipoprotein profiles of 20 post-menopausal women treated with cyclic conjugated oestrogens (0.625 or 1.25 mg) and medroxyprogesterone acetate (10 mg for 7 days) were compared to those of 18 untreated women of similar age and menopausal status. No statistically significant between-group differences were observed during the 18-mth period for cholesterol, triglycerides or lipoprotein distribution. After 12 mth, a significant shift in lipoprotein distribution manifested in the treated and untreated groups. The proportion of high-density lipoproteins significantly increased and that of the low-density lipoproteins significantly decreased. Although the shift was more pronounced in the treated group, there was no significant difference between the treated and untreated groups. These results indicated that such relatively nonandrogenic progestins as medroxyprogesterone acetate, have no adverse effects on the lipid milieu of post-menopausal women when used with long-term oestrogen therapy.

Cholesterol↗

The effect of exercise on the circumvaginal muscles in postpartum women.

The effect of exercise on pressure developed by the circumvaginal muscles (CVM) in postpartum women was studied. The CVM assessment system described earlier by Dougherty, Abrams, and McKey used an intravaginal balloon device (IVBD) developed from an impression and model of the vagina. The system (IVBD, pressure transducer and strip chart recorder) provided permanent CVM pressure tracings with high test-re-test reliability (n = 16; r = .85) for maximum pressure (MP). The hypothesis in the research reported here was that exercise with and without an IVBD, when compared to no exercise, would result in significantly higher MP and pressure over time (POT). Forty-five healthy PP volunteers were randomly assigned to a 10-minute per day home training program, for six weeks. The baseline and six-week assessments consisted of CVM pressure tracings during contraction. Dependent variables were MP (highest pressure attained) and POT (area under the pressure curve). Although no significant differences were found between the home training groups, greater improvement was found in the exercise groups. Variability within subjects partly accounts for the results. Pressure changes before and after pregnancy and before and after CVM exercise are demonstrated in a case study. The findings support the use of CVM exercise in the postpartum.

Exercise↗