Combined Effects of Pelvic Floor Retraining and Hypopressive Exercises in Uterine Prolapse Outcomes
2026年6月8日 更新者：Riphah International University
Combined Effects of Pelvic Floor Functional Movement Retraining and Hypopressive Exercises on Pain, Urogynecological Symptoms, and Quality of Life in Uterine Prolapse
One common pelvic floor condition, particularly in postpartum or later life, is uterine prolapse. It is caused by weak pelvic floor muscles and connective tissues and often presents with pain, urinary incontinence, and reduced quality of life. Although pelvic floor muscle training (PFMT) is commonly used, newer methods such as Hypopressive Exercises (HE) and Pelvic Floor Functional Movement Retraining (PFFMR) offer promising approaches. HE focuses on posture and breathing strategies to reduce intra-abdominal pressure, while PFFMR retrains pelvic stability and function through integrated movement patterns. This study aims to evaluate the combined effects of HE and PFFMR on pain, urogynecological symptoms, and quality of life in women with uterine prolapse, compared to single interventions.
This randomized clinical trial will include 32 women aged 30-60 years with stage I-II uterine prolapse at Ganga Ram Hospital, Lahore. Participants will undergo an 8-week program with supervised sessions three times per week. Outcomes will be assessed using the Pelvic Floor Bother Questionnaire (PFBQ), Numeric Pain Rating Scale (NPRS), and Prolapse Quality of Life Questionnaire (P-QoL), and analyzed using SPSS version 25.0.
研究概览
地位
招聘中
条件
详细说明
One common pelvic floor condition, particularly in postpartum or later life, is uterine prolapse.
It is caused by weak pelvic floor muscles and connective tissues, and it frequently manifests as pain, urine incontinence and a reduced quality of life.
Although traditional pelvic floor muscle training (PFMT) is still commonly utilized, newer methods like Hypopressive Exercises (HE) and Pelvic Floor Functional Movement Retraining (PFFMR) offer promising, supplementary approaches.
Whereas Hypopressive Exercises HE stresses posture and breathing strategies that lower intra-abdominal pressure and enhance pelvic organ support, Pelvic Floor Functional Movement Retraining (PFFMR) concentrates on retraining pelvic stability and function through integrated movement patterns.
The primary aim of this study is to evaluate the combined effects of Pelvic Floor Functional Movement Retraining and Hypopressive Exercises on pain, urogynecological symptoms and quality of life in women with uterine prolapse.
This study seeks to determine whether the combination provides superior outcomes compared to single interventions.
This randomized clinical trial study will include 32 female participants age 30 to 60 years, diagnosed with stage I and II uterine prolapse, selected through Non-probability Convenience sampling.
The setting of the study will be Ganga ram hospital Lahore.
Participants will undergo 8 weeks intervention program combining Hypopressive Exercises (HE) and Pelvic Floor Functional Movement Retraining (PFFMR), with sessions conducted three times per week under physiotherapist supervision.
Outcomes will be assessed at baseline and post-intervention using standardized tools: The Pelvic floor bother questionnaire (PFBQ) for urogynecological symptoms, the Numeric pain rating Scale (NPRS) for pain, and the Prolapse Quality of Life Questionnaire (P-QoL) for quality of life.
Data will be analyzed using SPSS version 25.0 to determine statistically significant changes pre- and post-intervention.
研究类型
介入性
注册 (估计的)
32
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习联系方式
- 姓名：Imran Amjad, PHD*
- 电话号码：03324390125
- 邮箱：imran.amjad@riphah.edu.pk
研究联系人备份
- 姓名：Imran Amjad, PHD*
- 电话号码：0515481826
- 邮箱：imran.amjad@riphah.edu.pk
学习地点
-
-
Punjab Province
-
Lahore、Punjab Province、巴基斯坦、54000
- 招聘中
- Ganga Ram Hospital
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接触：
- Ghulam Fatima, PhD*
- 电话号码：03034073057
- 邮箱：ghulam.fatima@riphah.edu.pk
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-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
接受健康志愿者
不
描述
Inclusion Criteria:
- Females aged 30-60 years.
- Diagnosed with stage I and II uterine prolapse.
- women with ≥1 parity
- women who have had a vaginal delivery
Exclusion Criteria:
- Recent pelvic surgery (<6 months).
- Pregnancy or postpartum within 6 months.
- Neurological conditions affecting muscle control.
- Participation in pelvic floor rehab in the past 6 months.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：Group A: Functional Movement Retraining with Hypopressive Exercise
Participants in Group A will receive a combined intervention of pelvic floor functional movement retraining (PF-FMR) and hypopressive exercises.
PF-FMR will focus on posture correction, diaphragmatic breathing, and integrating pelvic floor contractions into functional movements such as squats, bridges, and walking to improve muscle activation, alignment, and core stability.
Hypopressive exercises will aim to reduce intra-abdominal pressure and activate deep core and pelvic floor muscles through apnea-based breathing in different positions, contributing to improved pelvic floor tone and symptom relief in women with pelvic organ prolapse.
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Participants in Group A will receive a combined intervention consisting of pelvic floor functional movement retraining (PF-FMR) and hypopressive exercises (HE).
The intervention will be delivered in supervised sessions three times per week for 8 weeks, each lasting 30-45 minutes.
The PF-FMR component will include posture correction, diaphragmatic breathing, and integration of pelvic floor muscle contractions into functional movements such as squats, bridges, and walking.
These exercises aim to improve voluntary muscle activation, spinal-pelvic alignment, and core stability,(34) and significant improvements in pelvic floor dysfunction with functionally integrated physiotherapy.
In addition, hypopressive exercises will be included to reduce intra-abdominal pressure and stimulate involuntary activation of pelvic floor and deep core muscles through apnea-based breathing techniques.
Participants will perform HE in various postures (supine, seated, and standing).
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|
有源比较器：Group B: Functional Movement Retraining
Group B will receive pelvic floor functional movement retraining (PF-FMR) alone for the same duration and frequency as Group A. The program will focus on pelvic floor muscle training integrated into functional movements such as bridges, squats, postural correction, and diaphragmatic breathing with pelvic floor contraction to improve core-pelvic coordination, muscle control, alignment, and endurance, aiming to reduce pelvic organ prolapse symptoms and improve quality of life.
Participants will also follow a home exercise program and maintain adherence logs to track progress.
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Group B will receive pelvic floor functional movement retraining (PF-FMR) alone, following the same frequency and duration as Group A. This group will focus on active pelvic floor muscle training embedded within dynamic postures and everyday functional tasks.
Exercises will include bridges, squats, postural corrections, and diaphragmatic breathing combined with pelvic floor contraction to facilitate core-pelvic coordination.
The objective is to retrain muscle control, improve pelvic alignment, and enhance pelvic floor endurance and PFMT to be effective in reducing symptoms of pelvic organ prolapse and improving quality of life.
Like Group A, participants in Group B will also be instructed to follow a home program of prescribed exercises, with progress tracked through self-maintained adherence logs.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Numerical Pain Rating Scale (NPRS)
大体时间：8 weeks
|
For people with musculoskeletal illnesses, the NPRS is a valid, internally consistent, and generalizable indicator of clinical and experimental pain severity.
On a scale of 0 to 10, where 10 represents "the worst pain imaginable" and 0 represents "no pain at all," participants scored their present level of discomfort.
Participants also evaluated their lowest degree of discomfort and worst pain during the previous week in order to gauge the variability and intensity of pain.
For statistical analysis, the average of all pain assessments was used.
The NPRS is regarded as a valid and acceptable pain intensity scale.
High test-retest reliability (r=0.96 and 0.95) has been demonstrated by NPRS.
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8 weeks
|
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Pelvic floor bother questionnaire (PFBQ)
大体时间：8 weeks
|
Based on clinical interviews and a review of popular surveys like the Urinary Distress Inventory, Pelvic Floor Distress Inventory (PFDI), and Pelvic Floor Impact Questionnaire (PFIQ), the Cleveland Clinic pelvic floor staff created the validated PFBQ.
USI, urgency, frequency, UUI, POP, dysuria, dyspareunia, defecatory dysfunction, fecal incontinence, and the respondent's handicap are all assessed by the PFBQ.
The questionnaire has nine elements, each with a score ranging from 0 to 5. The total score ranges from 0 to 45 points, where 0 denotes no discomfort and 45 denotes a higher level of disability.
To get a value between 0 and 100, the questionnaire's total score is multiplied by 20.(30) PFBQ is a valid and reliable tool for assessing the symptoms of bother and severity in women with pelvic floor dysfunction.
The test-retest reliability of the PFBQ is excellent (0.998, p < 0.0001)
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8 weeks
|
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Prolapse Quality of Life Questionnaire (P-QoL)
大体时间：8 weeks
|
General health (1 item), prolapse impact (1 item), role limitations (2 items), physical limitations (2 items), social limitations (3 items), personal relationships (2 items), emotions (3 items), sleep/energy (2 items), and severity measures (4 items) are the nine quality of life domains that are represented by the 20 self-reported questions that make up the P-QoL questionnaire.
Each domain has a score between 0 and 100.
Lower ratings signify a good quality of life, whereas higher values imply a larger degradation of quality of life.
P-QoL IS a valid tool with test-retest reliability high in all cases, with values from 0.725 to 0.938.
All the values were statistically significant (p < 0.001)
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8 weeks
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Zunaira Bilal、Riphah International University
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Gray LD, Kreger AS. Rabbit corneal damage produced by Pseudomonas aeruginosa infection. Infect Immun. 1975 Aug;12(2):419-32. doi: 10.1128/iai.12.2.419-432.1975.
- Merville C, Dosne AM, Caen JP. [Vascular subendothehlium: structure and functions (author's transl)]. Pathol Biol (Paris). 1976 Dec;24 Suppl:18-22. French.
- Hiramatsu M, Hatakeyama K, Abe I, Minami N. [Changes of ground substances and effect of some anti-inflammatory drugs in cotton pellet granuloma (author's transl)]. Josai Shika Daigaku Kiyo. 1977;6(1):123-33. No abstract available. Japanese.
- Joyce LD, Smith JM, Mauer HG, Ameli M, Lillehei RC. Zymosan-induced resistance to endotoxin and hemorrhagic shock. Adv Shock Res. 1978;1:125-47.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2025年4月2日
初级完成 (估计的)
2026年6月2日
研究完成 (估计的)
2026年8月15日
研究注册日期
首次提交
2026年6月8日
首先提交符合 QC 标准的
2026年6月8日
首次发布 (实际的)
2026年6月11日
研究记录更新
最后更新发布 (实际的)
2026年6月11日
上次提交的符合 QC 标准的更新
2026年6月8日
最后验证
2026年5月1日
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- REC/RCR & AHS/25/0523
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
不
药物和器械信息、研究文件
研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
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