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Effects of Paula Exercises and Tibial Nerve Stimulation in Stress Urinary Incontinence

4. maj 2026 opdateret af: Riphah International University

Combine Effects of Paula Exercises and Tibial Nerve Stimulation on Incontinence, Pelvic Floor Muscles Strength, Sexual Function and Quality of Life in Stress Urinary Incontinence

The aim of this study is to compare the combined effects of Paula method & tibial nerve stimulation on incontinence, pelvic floor muscles strength, sexual function and quality of life in stress urinary incontinence

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This study will be randomized controlled trial and will be conducted in Arshian Hussnain Medical Clinic and at Marie Stopes Society. Non probability convenience sampling technique will be used and 56 participants will be recruited in study after randomization. Inclusion criteria will be females aged 30-45 years, multiparous women (≥2 full-term vaginal delivery). Exclusion criteria will be Neurological disorders, pregnancy and dermatological conditions .The subjects will be divided into two groups. Group A will receive Paula exercise and Tibial nerve stimulation. Group B will receive only Paula exercises. Both groups will receive baseline treatment which will include pelvic floor muscle contractions. The total duration of treatment will be 8 weeks and there will be 2 sessions each week. Outcomes assessed will be urinary function, pelvic floor muscles strength, sexual function & quality of life. Outcomes will be assessed using validated tools such as the IIQ-7, Modified Oxford Scale, FSFI, and SF-36. After data collection, it will be analyzed by using SPSS version 21.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

52

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 6400
        • Rekruttering
        • Arshian Hussnain Medical Clinic
        • Kontakt:
        • Ledende efterforsker:
          • Fizza Tahir, MSPT(WH)

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen

Tager imod sunde frivillige

Ja

Beskrivelse

Inclusion Criteria:

  • Multiparous women (≥2 full-term vaginal deliveries)
  • Clinical diagnosis of stress urinary incontinence (confirmed by cough stress test)
  • Duration of symptoms ≥3 months
  • Ability to correctly perform pelvic floor contractions (confirmed by digital examination)

Exclusion Criteria:

  • Neurological disorders (e.g., multiple sclerosis, spinal cord injury)
  • Mixed or urge urinary incontinence as the predominant type
  • Previous pelvic surgery or incontinence-related procedures within the past year
  • Current pregnancy or <6 months postpartum
  • Pelvic organ prolapse beyond stage II (POP-Q system)
  • Current use of other incontinence therapies (e.g., medication, PTNS, PFMT)
  • Diagnosed malignancy
  • Diagnosed psychiatric disorder
  • Pregnancy
  • Diagnosed dermatological condition
  • Participants who are currently enrolled in other clinical trials to avoid potential confounding factors.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Paula Exercises & Tibial Nerve Stimulation
Paula exercises involve contracting circular muscles of the body (especially facial muscles like the orbicularis oris and orbicularis oculi) to stimulate pelvic floor activity indirectly and for tibial stimulation Transcutaneous (TTNS) approach will be used
Andet: Paula Exercises
  • Frequency: 2 sessions per week
  • Session Duration: 20 minutes
  • Repeated voluntary contractions of eye muscles (e.g., squinting) and mouth muscles (e.g., puckering lips), abdominal contractions followed by pelvic contractions.
  • Controlled breathing and postural awareness
  • Each type of contraction repeated 10-15 times per session
  • 30-second rest between sets, total 20 sets
  • Duration:8 weeks
Andet: Tibial Nerve Stimulation
  • Frequency: 20 Hz
  • Pulse Width: 200 microseconds
  • Intensity: Adjusted to elicit mild toe flexion ,0 to 10 mA
  • Session Duration: 20 minutes
  • Frequency: 2 sessions per week
  • Total Duration:8 weeks
Aktiv komparator: Paula Exercises
Paula exercises involve contracting circular muscles of the body (especially facial muscles like the orbicularis oris and orbicularis oculi) to stimulate pelvic floor activity indirectly
Andet: Paula Exercises
  • Frequency: 2 sessions per week
  • Session Duration: 20 minutes
  • Repeated voluntary contractions of eye muscles (e.g., squinting) and mouth muscles (e.g., puckering lips), abdominal contractions followed by pelvic contractions.
  • Controlled breathing and postural awareness
  • Each type of contraction repeated 10-15 times per session
  • 30-second rest between sets, total 20 sets
  • Duration:8 weeks

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incontinence Impact Questionnaire IIQ 7:
Tidsramme: 8th week
The Incontinence Impact Questionnaire (IIQ-7) is a brief, 7-item instrument used to assess the impact of urinary incontinence on a woman's quality of life.
8th week
Modified Oxford Scale
Tidsramme: 8th week
The Modified Oxford Scale is a clinical tool used to assess the strength of pelvic floor muscles through vaginal or rectal examination. It uses a 6-point scale (0 to 5), where 0 indicates no contraction and 5 represents a strong contraction. A Cronbach's alpha is not typically reported for this scale because it is based on a single-item, ordinal rating by a clinician, rather than a multi-item questionnaire
8th week
Female Sexual Function Index FSFI
Tidsramme: 8th week
The Female Sexual Function Index (FSFI) is a 19-item self-report questionnaire designed to assess six domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain. Each domain is scored individually and contributes to a total score that reflects overall sexual function, with higher scores indicating better function
8th week
SF 36
Tidsramme: 8th week
The Short Form-36 Health Survey (SF-36) is a widely used 36-item questionnaire designed to measure health-related quality of life across eight domainsThese domains contribute to two summary scores: the Physical Component Summary (PCS) and the Mental Component Summary (MCS).
8th week

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Riphah International University

Efterforskere

  • Ledende efterforsker: sobia ghafoor, MSPT-OM, Riphah International University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

  • Yang X, Wang X, Gao Z, Li L, Lin H, Wang H, et al. The Anatomical Pathogenesis of Stress Urinary Incontinence in Women. Medicina. 2023;59(1):5.
  • Mushtaq S. EFFICACY OF EXERCISE-BASED TECHNIQUES TO TREAT STRESS URINARY INCONTINENCE IN FEMALES EXCEPT FOR KEGELS TECHNIQUE: A NARRATIVE REVIEW OF THE LATEST EVIDENCE. Pakistan Journal of Rehabilitation. 2024;13(1):17-29.
  • Aliyu SU, Hanif SM, Lawal IU. Effect of Paula exercise method on functional outcomes of women with post fistula repair incontinence: a protocol for randomized controlled trial. BMC Women's Health. 2021;21(1):101.
  • Lee UJ, MacDiarmid S, Matthews CA, Gillespie E, Peters KM. Tibial Nerve Stimulation for Urge Urinary Incontinence and Overactive Bladder: Narrative Review of Randomized Controlled Trials and Applicability to Implantable Devices. Advances in Therapy. 2024;41(7):2635-54.
  • Al-Danakh A, Safi M, Alradhi M, Almoiliqy M, Chen Q, Al-Nusaif M, et al. Posterior tibial nerve stimulation for overactive bladder: mechanism, classification, and management outlines. Parkinson's Disease. 2022;2022(1):2700227.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. oktober 2025

Primær færdiggørelse (Anslået)

1. juni 2026

Studieafslutning (Anslået)

1. juli 2026

Datoer for studieregistrering

Først indsendt

4. maj 2026

Først indsendt, der opfyldte QC-kriterier

4. maj 2026

Først opslået (Faktiske)

8. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • REC/RCR & AHS/25/0502

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

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