Effect of Postural Reeducation Versus Pelvic Floor Muscle Training on Stress Urinary Incontinence

The purpose of the study is to evaluate the effects of postural reeducation compared to pelvic floor muscle training on urinary incontinence (UI) symptoms, the impact of UI, and quality of life (QoL) in women experiencing stress urinary incontinence (SUI)

Study Overview

• Status: Completed
• Conditions: Stress Urinary Incontinence
• Intervention / Treatment: Other: Postural reeducation; Other: Pelvic floor exercises

Detailed Description

The study is designed as a randomized- controlled trial. It will be carried out on women suffering from stress urinary incontinence referred after urology consultations to the Physiotherapy Clinic in Soad Kafafy hospital.

UI, particularly SUI, affects up to 28% of the population and occurs during activities like coughing or sneezing due to inadequate urethral closure pressure. The pelvic floor muscles play a critical role in supporting pelvic organs and maintaining continence. Pelvic floor dysfunction is a significant contributor to SUI. Postural dysfunction can increase mechanical stress and lead to pelvic floor dysfunction. Postural re-education techniques aim to correct imbalances and improve pelvic floor muscle activity, potentially alleviating SUI symptoms by restoring muscle efficiency and enhancing continence.

• Study Type: Interventional
• Enrollment (Actual): 50
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza, Egypt
    • Faculty of physical therapy, MUST University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Fifty females with stress urinary incontinence.
• Age of 30-40 years.
• Body mass index (BMI) > 30 kg/m2

Exclusion Criteria:

• Genital prolapse grade 3 or 4 based on Pelvic Organ Prolapse Quantification Classification (POP-Q).
• Overactive bladder (OAB)
• Functional impairment (Barthel scale <85 points).
• Neurological or cognitive impairment (mini mental examination <24 points).
• Any other type of urinary incontinence.
• Pregnancy.
• History of spinal, hip, knee or foot surgery, pelvic and abdominal surgery (including cesarean section)
• Smoking, chronic cough, history of respiratory diseases, osteoporosis (self-reported).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Postural reeducation; They will receive a program of postural reeducation with a home program for 12 weeks.	Other: Postural reeducation; The program will include postural awareness, stretching, McKenzie's method, and manual therapy for 12 weeks.
Experimental: Pelvic floor exercises; They will receive a program of pelvic floor exercises with a home program for 12 weeks.	Other: Pelvic floor exercises; The program will include pelvic floor exercises for 12 weeks. Three sets of 10 long contractions will be performed, each sustained for 6-8 seconds, three times a day. After each contraction, participants will be asked to rest for the same period. Two series of 10 fast contractions will be recommended, consisting of short, quick exercises of 1- to 2-second contractions, followed by long, sustained exercises lasting 5-10 seconds.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Urinary incontinence (UI) symptoms	UI symptoms will be measured using a 48-hour Pad Test [14]. This is a standardized test for assessing urine leakage that can be performed at home[15]. Women replace pads as needed over the course of 48 hours. The results are calculated by subtracting the net weight of used pads from the total weight of non-used pads. The Pad Test results can be classified as mild (4-20 g), moderate (21-74 g), or severe UI (> 75 g).	12 weeks
Urinary incontinence (UI) impact	It will be assessed using the International Consultation Incontinence Short-Form (ICIQ-UI-SF). UI impact will be derived from the values of the third question assessing overall impact ("How much does leaking urine interfere with everyday life?", ranging from 0 to 10), with a higher score indicating a greater UI impact.	12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Urinary incontinence-Quality of life (UI-QoL)	It will be assessed using the International Consultation Incontinence Short-Form (ICIQ-UI-SF). The UI-QoL will be calculated using the questionnaire's final score (range from 0 to 21), which is the total of the three items, with a higher score indicating more severe UI and a bigger influence on QoL.	12 weeks

Collaborators and Investigators

• Sponsor: Misr University for Science and Technology
• Investigators: Principal Investigator: Sally Mohamed Saeed, PhD, Lecturer, MUST university; Principal Investigator: Malak Adel Elmahdy, PhD, Lecturer, Al Hayah University

Study record dates

Study Major Dates

• Study Start (Actual): October 25, 2024
• Primary Completion (Actual): January 25, 2025
• Study Completion (Actual): February 1, 2025

Study Registration Dates

• First Submitted: October 19, 2024
• First Submitted That Met QC Criteria: October 19, 2024
• First Posted (Actual): October 22, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 20, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Urogenital Diseases; Mental Disorders; Male Urogenital Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urination Disorders; Lower Urinary Tract Symptoms; Urological Manifestations; Behavioral Symptoms; Elimination Disorders; Urinary Incontinence; Enuresis; Urinary Incontinence, Stress
• Other Study ID Numbers: P.T.REC/012/005133

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No