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

4. mai 2026 oppdatert av: 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

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert 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.

Studietype

Intervensjonell

Registrering (Antatt)

52

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 6400
        • Rekruttering
        • Arshian Hussnain Medical Clinic
        • Ta kontakt med:
        • Hovedetterforsker:
          • Fizza Tahir, MSPT(WH)

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen

Tar imot friske 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

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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
Annen: 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
Annen: 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
Annen: 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

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Riphah International University

Etterforskere

  • Hovedetterforsker: sobia ghafoor, MSPT-OM, Riphah International University

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

  • 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.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. oktober 2025

Primær fullføring (Antatt)

1. juni 2026

Studiet fullført (Antatt)

1. juli 2026

Datoer for studieregistrering

Først innsendt

4. mai 2026

Først innsendt som oppfylte QC-kriteriene

4. mai 2026

Først lagt ut (Faktiske)

8. mai 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

8. mai 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

4. mai 2026

Sist bekreftet

1. mai 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • REC/RCR & AHS/25/0502

Plan for individuelle deltakerdata (IPD)

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NEI

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Nei

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