The impact of training using the Bebo® method and assisted by the Winner Flow v2.0 whistle in women after vaginal delivery on pelvic floor muscle function and diastasis recti

The study will include 60 women aged 25 to 35 years who are 6 to 7 weeks postpartum following their first vaginal delivery. To assess the effectiveness of the intervention, all participants will undergo a comprehensive evaluation before and after the 4-week intervention period. The assessments will include: Completion of the UDI-6 (Urogenital Distress Inventory) to evaluate urinary continence status, Measurement of pelvic floor neuromuscular activity using surface electromyography (EMG), Evaluation of rectus abdominis diastasis using ultrasound imaging (USG), Assessment of balance and plantar pressure distribution using the FreeMed Base pedobarographic platform, Analysis of pelvic alignment with the Duometr OP-1/P inclinometer, and Measurement of spinal and hip joint mobility using a goniometer. Participants A total of 60 women, aged 25 to 35 years, will be enrolled. All participants must be 6–7 weeks postpartum following their first vaginal delivery, and provide a medical clearance certificate confirming no contraindications to physical activity or study participation. Group Allocation and Intervention Participants will be randomly assigned into one of three study arms using a computer-generated random number sequence: Group 1: BeBo® Training Group Participants will undergo a 4-week individualized pelvic floor training program based on the BeBo® concept. Sessions will be conducted twice per week, under the supervision of a qualified physiotherapist. Group 2: BeBo® + Winner Flow Group This group will receive the same individualized 4-week BeBo® training program, with each session supported by the use of the Winner Flow v2.0 breathing device. Training sessions will also take place twice weekly, under the supervision of a trained therapist. The Winner Flow v2.0 is designed to promote controlled exhalation and intra-abdominal pressure modulation, thereby facilitating optimal pelvic floor muscle activation during exercise. BeBo® Training Protocol Each training session will consist of a 10-minute theoretical component and a 50-minute practical component. The program is classified as low-intensity according to the Borg scale. Each participant will maintain an exercise diary; more than one absence will result in exclusion from the program. The practical component will include: awareness, strengthening, and mobilization exercises, relaxation exercises aimed at restoring autonomic balance and reducing stress, integration of pelvic floor muscles into daily activities through posture correction, breathing, and balance training. Exercises will be performed in various starting positions (standing, quadruped, knee–elbow, sitting, supine, side-lying, prone) with the use of simple equipment (large and small exercise balls, sensorimotor disk, foam roller, tennis ball, cherry pit bags). BeBo® Training with the Winner Flow v2.0 The modification consists of exhalation during deep muscle activation exercises through the Winner Flow v2.0 resistance device. Each participant places the mouthpiece in the mouth and exhales against resistance individually adjusted during the first session. Inhalation is performed through the nose, while exhalation is performed through the mouth. Procedure for Adjusting Resistance with the Winner Flow v2.0 In accordance with the device protocol, resistance is individually adjusted for each participant. While in a supine position with hips flexed at 45°, the participant performs a 10-second exhalation through the mouthpiece, initially set at level “1.” If exhalation lasts less than 4–5 seconds, resistance is reduced; if the target duration is easily achieved, resistance is increased. The resistance level is considered appropriate when a regular 10-second exhalation is achieved without excessive isometric contraction of the abdominal wall. As part of monitoring adherence to the intervention, an attendance list will be maintained and checked at each session. One absence during the entire cycle will be permitted. If this limit is exceeded, the participant will not be able to continue in the project