MoVo-guided Traditional Chinese Kegel Exercises for Preventing Postpartum Urinary Incontinence.
A Prospective Randomized Controlled Trial of MoVo-guided Liuzijue Combined With Traditional Levator Ani Exercise During Pregnancy for Preventing Postpartum Urinary Incontinence.
The goal of this clinical trial is to determine whether a prenatal exercise program integrating Liuzijue qigong with traditional levator ani training, guided by the MoVo (Motivation-Volition) theory and delivered via a supervised mobile application, can effectively prevent postpartum urinary incontinence and pelvic organ prolapse in pregnant women, compared with app-supervised conventional Kegel exercises and routine prenatal care.
The main questions it aims to answer are:
Does the integrated Liuzijue-and-levator-ani program reduce the incidence of postpartum urinary incontinence and prolapse more effectively than app-supervised Kegel exercises or routine care?
Can the MoVo-based behavioural framework (motivation enhancement, action planning, and self-monitoring) improve long-term adherence to pelvic floor training during pregnancy and the postpartum period?
What are the effects of the three interventions on pelvic floor muscle function, exercise self-efficacy, anxiety levels, and delivery outcomes?
Researchers will compare three parallel groups: (1) the integrated Liuzijue-and-levator-ani exercise group, (2) the app-supervised conventional Kegel exercise group, and (3) the routine care control group receiving only verbal instruction on pelvic floor exercises during standard prenatal visits. All three groups will be followed from enrolment through 6 weeks postpartum to determine whether the culturally adapted mind-body intervention offers superior pelvic floor protection beyond app-delivered Kegel training and routine care.
Participants will:
Be enrolled in the third trimester and randomly assigned to one of the three groups.
In the integrated exercise group, perform daily combined Liuzijue-and-levator-ani exercises via a supervised mobile app and attend periodic check-ins until 6 weeks postpartum.
In the app-supervised Kegel group, perform daily conventional Kegel exercises via the same mobile app platform with the same supervision schedule.
In the routine care group, receive only standard verbal instructions on Kegel exercises during regular antenatal check-ups, without app supervision.
Undergo outcome evaluations at enrolment, before delivery, and at the postpartum follow-up visit, including assessments of urinary incontinence, pelvic organ prolapse, exercise adherence, self-efficacy, anxiety, and any adverse events.
Aperçu de l'étude
Statut
Les conditions
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Yuxin Y Qian
- Numéro de téléphone: +8613247548104
- E-mail: 2710559471@qq.com
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
Accepte les volontaires sains
La description
Inclusion Criteria:
- Age ≥ 19 years
- Singleton pregnancy with cephalic presentation；
- No absolute contraindications to vaginal delivery；
- No history of urinary incontinence, pelvic organ prolapse, or pelvic floor surgery before pregnancy；
- Ability and willingness to comply with the full prenatal and postpartum follow-up schedule；
- Signed written informed consent.
Exclusion Criteria:
- History of second- or third-trimester miscarriage, recurrent miscarriage, or spontaneous preterm birth；
- Presence of pregnancy complications, such as severe preeclampsia, fetal distress, placenta previa, placental abruption, or symptoms of threatened preterm labour；
- Contraindications to exercise, including cervical shortening, cervical insufficiency, or unexplained vaginal bleeding or fluid leakage；
- Comorbid conditions, such as asthma, cardiovascular disease, hypertension, uncontrolled diabetes mellitus, or thyroid disease；
- Metabolic bone disease or limited joint mobility；
- Cognitive or psychiatric disorders that prevent the participant from completing diary records；
- Concurrent participation in another pelvic floor intervention study.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: La prévention
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Comparateur placebo: control group
Routine prenatal care with only verbal instructions on Kegel exercises (no app, no supervision).
|
Routine prenatal care with only verbal instructions on Kegel exercises (no app, no supervision)
|
|
Expérimental: App-Kegel group
App-supervised daily conventional Kegel exercises (same platform, no Liuzijue/MoVo).
|
App-supervised daily conventional Kegel exercises (same platform, no Liuzijue/MoVo).
|
|
Expérimental: TCM comprehensive group
App-supervised daily Liuzijue combined with levator ani training, guided by MoVo theory.
|
App-supervised daily Liuzijue combined with levator ani training, guided by MoVo theory.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Proportion of participants with urinary incontinence at 42 days postpartum, assessed by the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF)
Délai: 42 days postpartum
|
The ICIQ-UI SF is a validated, self-administered questionnaire that evaluates the frequency, volume, and impact of urinary incontinence (UI) over the previous 4 weeks.
Total scores range from 0 to 21, with higher scores indicating more severe symptoms.
This outcome is defined as the proportion of participants reporting any urine leakage (score ≥1) on the ICIQ-UI SF at the 42-day postpartum follow-up.
The chi-square test will be used to compare the incidence of urinary incontinence between the intervention and control groups.
|
42 days postpartum
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Adherence to the antenatal exercise intervention, assessed by exercise diary completion rate
Délai: at 3 months post-intervention
|
Adherence is evaluated by two combined measures: (1) exercise diary completion rate = (actual number of training sets completed / planned number of training sets) × 100%; and (2) the proportion of participants who perform active training on at least 4 days per week, with each training day defined as completing at least 50% of the planned sets.
The mean adherence rate and the proportion of adherent participants will be reported for the intervention group.
|
at 3 months post-intervention
|
|
Pelvic floor muscle strength assessed by the Modified Oxford Grading Scale.
Délai: 42 days postpartum
|
The Modified Oxford Grading Scale evaluates pelvic floor muscle contraction strength via vaginal palpation, with grades ranging from 0 (no contraction) to 5 (strong contraction).
Median and interquartile range will be reported for each group, and the Mann-Whitney U test will be used for comparison.
|
42 days postpartum
|
|
Change in self-efficacy for pelvic floor exercises, assessed by the Pelvic Floor Exercise Self-Efficacy Scale
Délai: Enrolment, 37 weeks of gestation, 42 days postpartum
|
The Pelvic Floor Exercise Self-Efficacy Scale is a validated self-report instrument that measures the participant's confidence in adhering to pelvic floor exercise.
Total scores range from 0 to 100, with higher scores indicating greater self-efficacy.
Assessments will be performed at three time points: enrolment, 37 weeks of gestation, and 42 days postpartum.
Mean ± standard deviation of scores and change from baseline will be reported for each group.
Repeated-measures analysis of variance (ANOVA) will be used to compare differences between groups.
|
Enrolment, 37 weeks of gestation, 42 days postpartum
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: ming M Yang, Guangzhou University of Chinese Medicine
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Maladies urogénitales
- Maladies urogénitales masculines
- Maladies urologiques
- Maladies urogénitales féminines
- Maladies urogénitales féminines et complications de la grossesse
- Troubles urinaires
- Symptômes des voies urinaires inférieures
- Manifestations urologiques
- Incontinence urinaire
- Conditions pathologiques, signes et symptômes
- Signes et symptômes
- Incontinence urinaire, Stress
Autres numéros d'identification d'étude
- GDSHLXHYJYB202608
Informations sur les médicaments et les dispositifs, documents d'étude
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