Effects of Diaphragmatic Breathing With Kegal Exercises on Pelvic Floor Muscle Function and Quality of Life Among Multigravida Women With Stress Incontinence

The goal of this clinical trial is to determine the effect of diaphragmatic breathing with kegel exercises on pelvic floor muscle function and quality of life among multigravida women with stress urinary incontinence The main question it aims to answer are The effect of diaphragmatic breathing in combination with Kegel exercises is significant in improving pelvic floor muscle function and quality of life among multigravida women with stress urinary incontinence.

The researcher will compare diaphragmatic breathing to kegel exercises as a standard treatment to see if it produces better results for treating SUI Participants will Perform diaphragmatic breathing with kegel exercises for 6 weeks Visit clinic every at the end of every week They will keep a diary regarding when they performed exercises

Study Overview

• Status: Active, not recruiting
• Conditions: Stress Urinary Incontinence (SUI)
• Intervention / Treatment: Other: Diaphragmatic Breathing; Other: Kegel exercises

• Study Type: Interventional
• Enrollment (Actual): 84
• Phase: Not Applicable

Contacts and Locations

Study Locations

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

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• • The population under study was adult women of age between 25-45 years

  • Women with the history of at least two parities
  • No previous history of undergoing any physical therapy treatment for SUI
  • The study included clinically diagnosed women with stress urinary incontinence
  • Study included grade 1-2 severity of SUI that can be treated conservatively
  • Women with both vaginal and c-section deliveries were included

Exclusion Criteria:

• Women with pelvic organ prolapse

  • Women that were menopausal or post-menopausal
  • Pregnant women and 6 months post-partum
  • Any other surgical and medical history (congenital urological disease or tumor of bladder)
  • Women with detrusor hyperreflexia
  • Any on-going Infection (vaginal lesion or UTI)
  • Women that had chronic pelvic pain
  • Women that had any sextual disorders
  • Women having any neurological problems

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experimental Group; This group received diaphragmatic breathing as experimental treatment along with kegel exercises as standard treatment	Other: Diaphragmatic Breathing; Patient lies supine with pillow under the head and knees. One hand on abdomen and other on chest Patient inhales deeply through the nose till the chest remains still and hand on the abdomen rises; Other Names: Deep breathing; Other: Kegel exercises; Patient lies supine with pillow under the head and knees Patient contracts the pelvic floor muscle like holding urine and sustain it for 10-15 seconds; Other Names: Pelvic floor exercises
Active Comparator: Control Group; This group only received kegel exercises as standard treatmeng	Other: Kegel exercises; Patient lies supine with pillow under the head and knees Patient contracts the pelvic floor muscle like holding urine and sustain it for 10-15 seconds; Other Names: Pelvic floor exercises

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pressure	a biofeedback device with vaginal probes was used to Measure pelvic floor muscle strength The probe connected to the biofeedback was inserted into the vagina and 55mm of Hg pressure was maintained by inflating the probe through the biofeedback. Strength was assessed by recording the maximum pressure exerted during the voluntary pelvic floor muscle contraction on command. Pressure was recorded in mm of Hg by the device. According to a research manometry results measured in cm H2O unit was categorized according to the modified oxford scale into 0-5 grading scales. 0 indication none and 5 indicating strong contraction to categorize the collected data.	Baseline (pre-intervention) and 6 weeks (post-intervention)
Endurance	A biofeedback device with vaginal probe was used to measure the endurance of pelvic floor muscles. The probe connected to the biofeedback was inserted into the vagina and 55mm of Hg pressure was maintained by inflating the probe through the biofeedback. Endurance was measured by recording the number of seconds a contraction was sustained over a period of 10 seconds. Pressure was recorded in number of seconds, 0 indication none and 10 indicating excellent endurance to categorize the collected data.	Baseline (pre-intervention) and 4 weeks (post-intervention)
Incontinence Quality of Life	Quality of life of patients suffering from Urinary Incontinence was measured using a questionnaire. The I-QOL questionnaire is based on 6 points scale ranging from 0 = none to 5= very great deal including 22 items. The questionnaire evaluates social life impacts, social embarrassment, psychological impacts and avoiding and limiting behavior associated with urinary incontinence. Total score was calculated using the formula: total score= (obtained sum by total items/110) x 100%. A low score indicated poor quality of life whereas a higher score indicated good quality of life among the patients of SUI. This questionnaire is used worldwide and is highly reliable and valid.	Baseline (pre-intervention) and 6 weeks (post-intervention)

Collaborators and Investigators

• Sponsor: Lahore University of Biological and Applied Sciences
• Investigators: Study Chair: Muhammad Tariq Shafi, Doctor of Physical Therapy, Lahore University of Biological and Applied Sciences; Principal Investigator: Maryam Afzal, Doctor of Physical Therapy, Lahore University of Biological and Applied Sciences

Study record dates

Study Major Dates

• Study Start (Actual): September 16, 2025
• Primary Completion (Estimated): May 5, 2026
• Study Completion (Estimated): May 10, 2026

Study Registration Dates

• First Submitted: March 30, 2026
• First Submitted That Met QC Criteria: April 12, 2026
• First Posted (Actual): April 17, 2026

Study Record Updates

• Last Update Posted (Actual): April 17, 2026
• Last Update Submitted That Met QC Criteria: April 12, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Kegel exercises; Deep breathing; Diaphragmatic breathing; Pelvic floor muscle; Multigravida
• 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: lcpt,375

Drug and device information, study documents

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