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Comparison of Rehabilitation Exercise Protocol (5R) and Swiss Ball Training for Postpartum Pelvic Floor Muscle Dysfunction

Comparison of Rehabilitation Exercise Protocol (5R) and Swiss Ball Training for Postpartum Pelvic Floor Muscle Dysfunction

Status
Recruiting
Phases
Unknown
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT07478627
Acronym
RESTORE-PF
Enrollment
88
Registered
2026-03-17
Start date
2026-03-23
Completion date
2026-04-25
Last updated
2026-03-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Pelvic Floor Muscle Dysfunction

Keywords

Postpartum Rehabilitation, Pelvic Floor Muscle Training, Swiss Ball Training, 5R Rehabilitation Protocol

Brief summary

Postpartum pelvic floor muscle dysfunction is a common condition affecting many women after childbirth. Weakness or impairment of the pelvic floor muscles can lead to symptoms such as urinary incontinence, pelvic discomfort, and reduced quality of life. Rehabilitation exercises targeting pelvic floor muscles are widely used to restore muscle strength and improve functional outcomes. The purpose of this study is to compare the effectiveness of a structured Rehabilitation Exercise Protocol (5R) with Swiss ball training in improving pelvic floor muscle function among postpartum women diagnosed with pelvic floor muscle dysfunction. The 5R protocol focuses on progressive rehabilitation strategies including relaxation, recruitment, resistance, repetition, and recovery of pelvic floor muscles. Swiss ball training involves exercises performed on a stability ball that aim to enhance core stability, pelvic control, and muscular coordination. Eligible postpartum women with pelvic floor muscle dysfunction will be randomly assigned to one of two groups. One group will receive the structured 5R rehabilitation exercise protocol, while the other group will participate in Swiss ball training exercises. Both interventions will be performed for a specified duration under the supervision of trained physiotherapists. Outcome measures will assess pelvic floor muscle strength, functional improvement, and symptom severity before and after the intervention period. The findings of this study may help determine the most effective rehabilitation strategy for improving pelvic floor muscle function and promoting recovery in postpartum women.

Detailed description

Postpartum pelvic floor muscle dysfunction (PFMD) is a significant health concern affecting women after childbirth. Pregnancy and vaginal delivery can lead to stretching, weakening, and potential injury to the pelvic floor muscles and connective tissues. As a result, many postpartum women experience symptoms such as urinary incontinence, pelvic organ prolapse, decreased pelvic stability, and reduced functional capacity. These symptoms can significantly affect daily activities, psychological well-being, and overall quality of life. Physiotherapy-based rehabilitation is considered one of the most effective non-invasive management strategies for postpartum pelvic floor dysfunction. Various exercise-based approaches have been proposed to strengthen pelvic floor muscles, improve neuromuscular control, and restore functional stability of the pelvic region. The Rehabilitation Exercise Protocol (5R) is a structured therapeutic program designed to promote systematic recovery of pelvic floor muscle function. The protocol typically incorporates progressive phases including muscle relaxation, activation and recruitment of pelvic floor muscles, resistance training, repeated contractions for endurance, and recovery strategies to enhance muscle performance and functional stability. Swiss ball training has also gained popularity as a rehabilitation method for postpartum women. Exercises performed on a Swiss ball introduce an element of instability, which stimulates activation of the core musculature including the pelvic floor, abdominal muscles, and lower back stabilizers. This training approach may improve coordination, balance, and pelvic stability while enhancing overall muscle strength. Despite the widespread use of both approaches, limited evidence exists comparing the effectiveness of the structured 5R rehabilitation protocol and Swiss ball training in postpartum pelvic floor rehabilitation. Therefore, this study aims to compare the therapeutic effects of these two interventions in postpartum women diagnosed with pelvic floor muscle dysfunction. This randomized controlled study will recruit postpartum women who meet the eligibility criteria. Participants will be randomly allocated into two groups. Group A will receive the Rehabilitation Exercise Protocol (5R), while Group B will undergo Swiss ball training exercises. Both interventions will be conducted over a defined treatment period under physiotherapy supervision. Outcome measures will be assessed at baseline and after completion of the intervention period to evaluate improvements in pelvic floor muscle strength, symptom severity, and functional outcomes. The results of this study will provide evidence regarding the most effective physiotherapy intervention for postpartum pelvic floor muscle rehabilitation and may guide clinical practice for improving postpartum recovery.

Interventions

BEHAVIORALRehabilitation Exercise Protocol (5R)

The Rehabilitation Exercise Protocol (5R) is a structured physiotherapy-based program designed to improve pelvic floor muscle strength and function in postpartum women. The protocol consists of progressive rehabilitation phases including relaxation of pelvic floor muscles, recruitment and activation exercises, resistance-based strengthening, repeated contractions to improve endurance, and recovery strategies. Participants will perform supervised pelvic floor exercises guided by a physiotherapist according to a structured treatment schedule throughout the intervention period.

BEHAVIORALSwiss Ball Training

Swiss ball training consists of a series of therapeutic exercises performed on a stability ball to improve pelvic floor muscle strength, core stability, and neuromuscular coordination in postpartum women. The exercises involve controlled pelvic tilts, bridging, seated balance exercises, and core activation movements that facilitate co-contraction of pelvic floor and abdominal muscles. The training program will be supervised by a physiotherapist and conducted according to the study protocol during the intervention period.

Sponsors

Rafia Abrar
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
No

Inclusion criteria

Females aged 20-40 years who have given birth within the last 6 months (normal deliveries). Delivery mood: both Normal and cesarean deliveries. Primiparous and Multiparous women. Women willing to participate in study. Confirmed pelvic floor dysfunction. Self-report of urinary incontinence (stress or urge) occurring at least once per week

Exclusion criteria

Women with high-risk pregnancies or postpartum complications (e.g., severe preeclampsia, postpartum hemorrhage). Participants with diagnosed musculoskeletal or neurological disorders affecting movement. History of pelvic surgery or severe musculoskeletal disorders. Women with diastasis recti exceeding a clinically significant threshold

Design outcomes

Primary

MeasureTime frameDescription
Pelvic Floor Muscle StrengthBaseline, 4 weeks and after 8 weeks of interventionPelvic floor muscle strength will be assessed using a standardized pelvic floor muscle assessment scale (such as the Modified Oxford Scale or perineometer measurement). The assessment will evaluate the strength and voluntary contraction of pelvic floor muscles in postpartum women with pelvic floor muscle dysfunction. Improvement in muscle strength will be compared between participants receiving the Rehabilitation Exercise Protocol (5R) and those undergoing Swiss ball training.

Countries

Pakistan

Contacts

CONTACTRafia Abrar, MSPTW
rafiaabrar345@gmail.com03066462413
CONTACTMontiha Azeem, MSPTN
muntahaazeem9@gmail.com03479717317
PRINCIPAL_INVESTIGATORRafia Abrar, MSPTW

The University of Lahore, Lahore

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Mar 18, 2026