Effect of Hypo-pressive Exercises and Pelvic Floor Muscle Training in Postpartum Stress Urinary Incontinence Women (SUI PFMT HE)

Effects of Hypo-pressive Exercises and Pelvic Floor Muscle Training on the Severity of Stress Urinary Incontinence and Quality of Life in Postpartum Women

Postpartum stress urinary incontinence is a widespread condition characterized by involuntary loss of urine during physical exertion, such as sneezing, coughing, or lifting heavy weights. Most frequently occur in multiparous women with vaginal delivery, who are obese, constipated, or with low maternal education. Damage to the levator ani muscle complex and adjacent fascia during childbirth affects urethral mobility and consequently results in sphincter insufficiency.

Hypopressive exercises involve breathing techniques that regulate the intra-abdominal pressure. HE has been recently recognized for benefits such as pelvic floor muscle (PFM) strength, endurance, postural control, core muscle activation, and respiratory capacity, which efficiently improve symptom severity and quality of life in postpartum women.

Pelvic floor muscle training (PFMT) is a set of frequent voluntary contractions designed to improve strength, coordination, and control. PFMT is considered as standard treatment protocol for urinary incontinence and other postpartum complications.

The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI-SF) and the Incontinence Quality of Life (IQOL) are used to assess symptom severity and quality of life, respectively. This study seeks to bridge that gap by evaluating and comparing the outcomes of HE and PFMT in postpartum women experiencing SUI. This research aims to support postpartum recovery, improve women's daily functioning, and enhance their overall well-being.

Study Overview

• Status: Active, not recruiting
• Conditions: Stress Urinary Incontinence in Women; Stress Urinary Incontinence (SUI)
• Intervention / Treatment: Other: hypo-pressive exercise; Other: pelvic floor muscle training

• Study Type: Interventional
• Enrollment (Estimated): 38
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Lahore University of Biological and Applied Sciences

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Women aged between 20 and 40 years old
• Multiparous women
• Postpartum women ≤ 6 months.
• Vaginal deliveries.
• Women diagnosed with stress urinary incontinence within 6 weeks to six months

Exclusion Criteria:

• Neurological disorder
• Metabolic issue
• Abdominal and pelvic surgery in previous years
• Mentally retarded
• Pregnant women

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: Hypopressive Exercises; Hypo-pressive Exercise (HE) training involves ribcage expansion and apnea to generate negative pressure, which in turn activates the deep core and pelvic floor muscles instinctively. Activating type I muscle fibers improves postural control, endurance, and coordination.	Other: hypo-pressive exercise; Exercise is performed 3 times per week for 6 weeks with moderate intensity for 20 min/session which includes diaphragmatic breathing, apnea, postural alignment (standing, seated, kneeling), and pelvic floor co-activation).
Active Comparator: Pelvic Floor Muscle Training; Pelvic Floor Muscle Training (PFMT) through voluntary contraction and resistance training strengthens pelvic floor musculature. In addition, these exercises have the potential to improve control over urine and fecal incontinence.	Other: pelvic floor muscle training; Exercise is performed 3 times per week for 6 weeks with submaximal voluntary contraction (include both slow holds and quick flicks) for 20 min/session (each session includes multiple sets of 8 repetitions, hold for 5 seconds, with rest intervals). These Kegel exercises are performed in different positions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Symptoms severity	Symptom severity due to SUI will assessed by International Consultation on Incontinence Questionnaire Urinary Incontinence short form (ICIQUI-SF) is a standardized, validated, self-administered questionnaire used to assess the severity of urinary incontinence (UI), influence quality of life, and situational triggers of leakage. It consists of four items: frequency of urine leakage, amount of urine leakage, overall impact of UI on daily life (rated on a 0-10 scale), and a self-diagnostic item asking when urine leaks (non-scored). The ICIQ-UI-SF showed a Cronbach's alpha value from 0.7 to 0.8, representing good internal consistency	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incontinence Quality of life	Incontinence Quality of life (I-QOL) is a self-assessment tool that is repeatedly utilized in people with UI. The 22-item I-QOL has three subscales: social embarrassment (SE), psychosocial impact (PSI), and avoidance and limiting behaviors (ALB). It based on Likert scale which comprises of five point, i.e. 1=always, 2=often, 3=sometimes, 4=rarely and 5=never. The IQOL showed a Cronbach's alpha value was 0.96, representing good internal consistency.	6 weeks

Collaborators and Investigators

• Sponsor: Lahore University of Biological and Applied Sciences

Study record dates

Study Major Dates

• Study Start (Actual): December 22, 2025
• Primary Completion (Estimated): May 22, 2026
• Study Completion (Estimated): May 22, 2026

Study Registration Dates

• First Submitted: December 22, 2025
• First Submitted That Met QC Criteria: December 22, 2025
• First Posted (Actual): January 7, 2026

Study Record Updates

• Last Update Posted (Actual): February 4, 2026
• Last Update Submitted That Met QC Criteria: February 2, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Pelvic floor muscle training; Quality of life; Hypopressive exercises; Post-partum stress urinary incontinence
• Additional Relevant MeSH Terms: Urogenital Diseases; Male Urogenital Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urination Disorders; Lower Urinary Tract Symptoms; Urological Manifestations; Urinary Incontinence; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Urinary Incontinence, Stress
• Other Study ID Numbers: DPT/ERB/29; U1111-1332-3272 (Registry Identifier: Isma Habib)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: After the publication of the research
• IPD Sharing Time Frame: July 2026- till any update
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

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