Dysmenorrhea is menstrual pain of uterine origin that can be classified as primary (PD) or secondary (SD). The worldwide prevalence of dysmenorrhea has been estimated in previous systematic reviews; however, these results are often limited by the focus on specific populations, or the inclusion of studies published only in English. Therefore, we estimated the worldwide prevalence of dysmenorrhea of both PD and SD. In this systematic review, we searched 6 databases for studies reporting the prevalence of dysmenorrhea published between 2000 and 2024, without language restriction. The risk of bias of the included studies was assessed using the Joana Briggs Institute tool. Meta-analysis was conducted in Rstudio. The heterogeneity within meta-analyses was evaluated by I ² statistics. Subgroup analyses were performed by PD, SD, age group, and study setting to investigate sources of heterogeneity as well. The certainty of evidence was assessed using GRADE modified for prevalence studies. A total of 336 studies were included in this systematic review. Most of them were conducted in Asia (49.4%). The pooled worldwide prevalence of dysmenorrhea, PD, and SD were 71.3% (95% CI 68.7%-73.8%), 73% (95% CI 68%-78%), and 35% (95% CI 19%-56%), respectively. Dysmenorrhea was more prevalent in Central America (89.6%), Sri Lanka (97.7%), among adults (73.3%), and at universities (78.4%). All subgroup analyses showed high heterogeneity (I ² = 99.5%-100%) with very low certainty of evidence. This high prevalence of dysmenorrhea worldwide highlights the need for healthcare providers and public health organizations to address menstrual pain's global burden.

Introduction: Pelvic floor muscle training (PFMT) exercises and neuromuscular electrical stimulation (NMES) are described as conservative interventions to prevent or treat female stress urinary incontinence (SUI). However, it has not been described yet the effect of PFMT associated to intravaginal NMES which evaluated the cost-effectiveness and cost-utility of treating. Aims: To evaluate the effects of intravaginal NMES associated with the PFMT protocol on urinary loss and quality of life in women with SUI and to evaluate the cost-effectiveness and cost-utility and pelvic floor muscle in women with SUI. Methods: Randomized controlled trial study with economic evaluation. Inclusion criteria are woman (biological), aged ≥ 18 years old and with a report of SUI ≥ once/week. Exclusion criteria are presence of vaginal or urinary infection, virginity, being in the gestational or puerperium period, or neurological disease. Participants will undergo physical therapy assessment and intervention: anamnesis, pelvic floor muscle assessment by vaginal palpation and manometry (Peritron^TM), questionnaires (Short-Form 6 Dimensions—Brazil (SF-6D), King's Health Questionnaire (KHQ) and King´s Health Questionnaire for Scoring Algorithm), health costs, and voiding diary. Participants will be randomly allocated into 3 groups: CG (control group), IG 1 (intervention group 1, PFMT), and IG2 (intervention group 2, PFMT + NMES). The statistical analysis will be performed by intention to treat, and multivariate analysis of mixed effects will be used to compare outcomes. Effect size measurements will be calculated and will be provided by Cohen’s d test. A significance level of 5% will be adopted. Additionally, the incremental cost-effectiveness and incremental cost-utility ratios will be used. Discussion: This protocol can corroborate with the literature in order to identify the effect of techniques, based on the possibility of confirming the hypothesis that the NMES associated with PFMT performed concurrently will be the best treatment option; considering the effectiveness, cost-effectiveness, and cost-utility analysis, it will be used as an option for optimization of the treatment of SUI. Trial registration: Brazilian Registry of Clinical Trials (ReBEC) ID: RBR-6gtzg4. Registered on September 3, 2019.

Introduction: Occupational therapists and physiotherapists aim to promote health, prevent various diseases and help people in their rehabilitation processes. So far, there is a paucity of understanding of the big picture of how the new paradigm of planetary health (PH) is connected to the education and practice of these professionals.Methods: This research aimed to address this gap by investigating and deploying a bibliometric analysis to elucidate the pivotal role of occupational therapists and physiotherapists in addressing PH challenges. The ultimate goal is to construct a comprehensive framework crosschecking the bibliometric analysis and the collection of 10 case studies selected by experts to outline how best practices in occupational therapy and physiotherapy, related to the three pillars of sustainability and the UN's Sustainable Development Goals (SDGs), can contribute to increasing PH.Results: The bibliometric analysis revealed four major research strands: 1) enhancing patient care and quality of life; 2) integrating sustainability in health care and rehabilitation; 3) professional development and clinical competence; and 4) evidence‐based practice and quality improvement. Moreover, further temporal analysis revealed how the topic evolved, from advancing evidence‐based practice and clinical effectiveness, exploring the strengthening of health care and person‐centred practices, to connecting the topic to aspects also predicted by the SDGs, such as integrating environmental and climate concerns in therapy and addressing psychological and self‐care impacts on health. The case studies confirmed this trend, and a framework of PH in occupational therapy and physiotherapy through the lens of the SDGs was developed to support future research and practitioners in advancing this research field.Conclusions: Occupational therapists and physiotherapists are essential players in public health and can integrate sustainability at every level of practice, from using resources during therapy sessions to advocating for more sustainable lifestyles.