Urinary Incontinence (UI)
Conditions
Keywords
Urinary Incontinence, pelvic floor, muscle strength, Quality of life, postpartum women
Brief summary
This study will be a randomized clinical trial with a sample size of 60 postpartum females. The setting of the study will be Bilal Medicare, Sargodha. 60 postpartum women will be included based on age, parity, mode of delivery and type of urinary incontinence. Women with primary gravida, cesarean section and urge and mixed urinary incontinence will be excluded. This study aims to compare the effectiveness of Hypopressive Exercises and the Paula Method in improving urinary incontinence severity, pelvic floor muscle strength and quality of life in postpartum women. Patients of both groups receive two treatment sessions per week over an 8-week period. Group A will be given Hypopressive exercise and Group B will be given Paula exercise protocol. Both groups will perform a standardized kegel exercises for pelvic floor muscle activation and strengthening as baseline treatment followed by their assigned interventions.
Detailed description
Stress urinary incontinence (SUI) is a prevalent pelvic floor disorder among postpartum women specially with multi-parity, significantly affecting their physical, psychological, and social well-being. Repeated vaginal deliveries can lead to pelvic floor muscle weakness, reduced support to pelvic organs, and impaired urinary control. Many non-invasive physical therapy strategies have gained popularity, particularly among women unable to effectively contract their pelvic floor muscles voluntarily. Two such techniques are Hypopressive Exercises and the Paula Method. Hypopressive exercises involve specific breathing patterns combined with postural adjustments that activate the pelvic floor through reflex mechanisms. In contrast, the Paula Method is based on the concept of muscular synergy among circular muscles. It utilizes rhythmic contractions of peripheral circular muscles (such as the eyes, lips, and sphincters) to stimulate the pelvic floor, making it especially beneficial for individuals with coordination issues or discomfort performing direct pelvic contractions. This study will be a randomized clinical trial with a sample size of 60 postpartum females. The setting of the study will be Bilal Medicare, Sargodha. 60 postpartum women will be included based on age, parity, mode of delivery and type of urinary incontinence. Women with primary gravida, cesarean section and urge and mixed urinary incontinence will be excluded. This study aims to compare the effectiveness of Hypopressive Exercises and the Paula Method in improving urinary incontinence severity, pelvic floor muscle strength and quality of life in postpartum women. Patients of both groups receive two treatment sessions per week over an 8-week period. Group A will be given Hypopressive exercise and Group B will be given Paula exercise protocol. Both groups will perform a standardized kegel exercises for pelvic floor muscle activation and strengthening as baseline treatment followed by their assigned interventions. Outcome measures will include the International Consultation on Incontinence Questionnaire (ICIQ-UI SF), Modified Oxford Scale for muscle strength, and Incontinence Impact Questionnaire (IIQ-7) for QoL assessment. Data will be statistically analyzed using SPSS version 25.
Interventions
(n=30) Each participant will receive treatment with hypopressive exercises for entire 08 weeks' intervention period.
OTHERPaula exercise
Each participant will receive treatment with the Paula method for entire 08 weeks' intervention period.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* • Multipara women from 25-40 years * Six weeks postpartum * Vaginal delivery method * Reported ≥1 episodes of urine leakage per week * Diagnosed with SUI (ICIQ-UI SF ≥6)
Exclusion criteria
* • No pelvic floor physiotherapy in last 6 months * Patients with any medical and gynaecological risk factors and /or conditions * Patients with any neurological problems, urinary tract infection, diabetes mellitus, hepatitis and ascites * Pelvic surgery in last 6 months * Mental or cognitive impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF) | 8 weeks | The ICIQ-UI SF is a standardized and internationally recognized tool for assessing the severity of urinary incontinence and its impact on quality of life. It consists of 4 questions; frequency of leakage, amount of urine lost, overall impact on daily life and self-diagnostic items (non-scored). |
| Modified Oxford Grading Scale (Manual Muscle Testing of Pelvic Floor) | 8 weeks | This clinical scale is used to assess pelvic floor muscle strength through vaginal palpation, grading the strength from 0 (no contraction) to 5 (strong contraction). It helps determine the baseline function and progress of pelvic floor rehabilitation. The scale uses a single-item score ranging from 0 to 5, based on the therapist's tactile evaluation of the pelvic floor contraction. Though subjective, its validity is supported through clinical correlation with manometric and EMG readings. It is especially useful in low-resource settings where instrumentation is unavailable. |
| Urinary Incontinence Impact Questionnaire - 7 (UIQ-7) | 8 weeks | The UIQ-7 is a subscale of the PFIQ-7 and is used to evaluate the impact of urinary incontinence on daily activities and social functioning. It is especially useful for measuring the subjective burden of incontinence on the patient's life. The UIQ-7 consists of 7 questions, each scored on a scale of 0 (not at all) to 3 (quite a bit), with a total score ranging from 0 to 21. Higher scores indicate greater impact on quality of life. |
Countries
Pakistan
Contacts
CONTACTImran Amjad, PhD
PRINCIPAL_INVESTIGATORHafiza Iqra Rubab, MSWHPT
Riphah International University
Outcome results
None listed