Healthy Adult Women, Pelvic Floor Muscle Exercise, Pelvic Floor Muscle Training
Conditions
Keywords
pelvic floor muscle training, pelvic floor muscle exercise, Healthy Adult Women, Comparison Models
Brief summary
Pelvic floor muscle training (PFMT) is an exercise approach designed to improve the strength, endurance, power, relaxation, or coordination of the pelvic floor muscles. It is recommended as a first-line treatment for urinary incontinence (stress, urge, mixed), pelvic organ prolapse, and fecal incontinence. Evidence also suggests its potential to enhance sexual function in both men and women. To teach proper pelvic floor contraction, individuals must first learn the anatomical location, structure, and function of these muscles. Various teaching strategies can support motor learning, such as verbal cues (commands or imagery), visual input (anatomical models or illustrations), physical guidance (tactile feedback), and environmental adjustments (comfortable positions, safe space). Yet, the choice of teaching method in clinical practice is currently based only on experience, not evidence. This study aims to compare the effectiveness of four different PFMT teaching models-brochure-based, verbal instruction-based, visual instruction-based, and external palpation-aided-in teaching correct pelvic floor contraction and improving awareness in healthy adult women. It will be conducted as a four-arm randomized controlled trial. Participants will be evaluated before the training, immediately after, and one week later. The findings from this study will help identify the most effective and practical approach for teaching PFMT. Although the study is conducted with healthy women without pelvic symptoms, the results will inform better training strategies for individuals with pelvic floor dysfunction, including those with urinary problems, chronic diseases, or pregnancy-related pelvic floor issues. Ultimately, this research seeks to fill a gap in the current literature and contribute to more evidence-based clinical practice.
Interventions
BEHAVIORALBrochure-Based Pelvic Floor Muscle Training
Brochure-based pelvic floor muscle training will be conducted by providing participants with a brochure containing information about the anatomy, functions, and importance of the pelvic floor, as well as instructions on how to contract the pelvic floor muscles. All educational content will be delivered solely through the brochure, and no additional verbal or written information will be provided to the participants. The brochure will include detailed explanations of pelvic floor muscle contractions and imagery techniques. Participants will be given 30 minutes to review the brochure and apply the training independently.
BEHAVIORALVerbal Instruction-Based Pelvic Floor Muscle Training
Verbal instruction-based pelvic floor muscle training involves providing participants with information about the anatomy, functions, and importance of the pelvic floor, as well as instruction on how to correctly contract the pelvic floor muscles. All explanations will be delivered verbally, and no additional equipment or visual aids will be used. During the training, imagery techniques based on verbal cues will be employed. Commonly used metaphors such as a hammock, a faucet, an elevator, or a ship will be utilized to facilitate imagery. Participants will be asked to focus on their pelvic floor and imagine the contractions, and they will be informed about the potential effects of these contractions during the session.
BEHAVIORALVisual-Aided Pelvic Floor Muscle Training
Visual-aided pelvic floor muscle training includes providing participants with information about the anatomy, functions, and importance of the pelvic floor, as well as training on how to properly contract the pelvic floor muscles. The training will be conducted using anatomical models, visual materials, and videos. Following the explanation of pelvic floor anatomy with models and visual aids, the function and importance of the pelvic floor will be presented through video demonstrations. During the session, the pelvic floor will be visually represented using common metaphors such as a hammock, a faucet, an elevator, or a ship, and these visuals will support the use of imagery techniques. Participants will be asked to focus on their pelvic floor and imagine the contractions, and they will be provided with information about the expected effects of the contractions.
BEHAVIORALExternal Palpation-Aided Pelvic Floor Muscle Training
External Palpation-Aided Pelvic Floor Muscle Training This training involves educating participants on the pelvic floor's anatomy, function, and importance, along with instructions on proper muscle contraction. After an educational session using anatomical models, visuals, and videos, external palpation is used to guide correct muscle activation. In a hook-lying position and fully clothed, participants receive light, transverse pressure from a physiotherapist on key pelvic floor muscles (ischiocavernosus, bulbospongiosus/bulbocavernosus, or perineum). The therapist observes real-time muscle response, provides feedback, and offers verbal cues. Imagery techniques (e.g., hammock, faucet, elevator, ship) may be used to support motor learning and awareness.
Sponsors
Izmir University of Economics
Dokuz Eylul University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age 18 years or older * Female * Willingness to participate in the study
Exclusion criteria
* Pregnancy * History of cesarean or vaginal delivery within the past 6 months * Previous pelvic floor muscle training * History of pelvic surgery * Currently receiving or having received treatment for pelvic organ prolapse
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mean Bladder Base Displacement During Pelvic Floor Muscle Contraction | Baseline (pre-training), immediately after training (within 1 hours of completion of training), and follow-up (7 days after training) | Pelvic floor muscle activity will be objectively assessed using transabdominal B-mode ultrasound, which allows real-time visualization of muscle movement. Participants will drink 500 ml of water and refrain from voiding before the test. While lying supine with knees flexed, a linear probe will be placed transabdominal suprapubically to visualize the bladder base. Bladder displacement during pelvic floor contraction will be measured by placing markers on the ultrasound image at rest and during contraction. The procedure will be repeated three times, and the average measurement in millimeters will be recorded. |
| Presence or Absence of Voluntary Pelvic Floor Muscle Contraction Assessed by Palpation | Baseline (pre-training), immediately after training (within 1 hours of completion of training), and follow-up (7 days after training) | The participants' ability to contract their pelvic floor muscles will be assessed by a specialized physiotherapist through external palpation and categorized as no voluntary contraction, weak, moderate, or strong contraction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Semi-Structured Form for Pelvic Floor Awareness | Baseline (pre-training), immediately after training (within 1 hours of completion of training), and follow-up (7 days after training) | A semi-structured questionnaire was developed to assess participants' knowledge and awareness regarding pelvic floor anatomy, function, dysfunction, and exercises. |
| Participant Satisfaction | Immediately after training (within 1 hours of completion of training) | Participant satisfaction with the training program will be assessed immediately after the intervention using a Visual Analog Scale (VAS). Participants will be asked to respond to two questions: (1) "How satisfied are you with the training you received?" and (2) "Do you think the training you received was useful?" Each question will be rated on a scale from 0 to 10, where 0 indicates "Not satisfied at all" or "Not useful at all" and 10 indicates "Extremely satisfied" or "Extremely useful." The responses will be recorded as continuous variables. |
Countries
Turkey (Türkiye)
Contacts
CONTACTIpek Yavas, MSc, PT, Lecturer
Outcome results
None listed