Pelvic Floor Disorders, Pregnancy
Conditions
Keywords
Pregnancy, Pelvic floor muscle endurance, Hydrotherapy, Land-based exercise, Pelvic floor muscle training
Brief summary
The goal of this retrospective study is to compare the effects of hydrotherapy and land-based exercise on pelvic floor muscle endurance in pregnant women. The main question it aims to answer is whether pelvic floor muscle endurance differs between women who participated in hydrotherapy and those who participated in land-based exercise. Researchers will compare existing clinical records of pregnant women who received hydrotherapy or land-based exercise. The study will examine pelvic floor muscle endurance measured using the Modified Oxford Grading (MOG) and other available pelvic floor assessments. The study will use information already recorded during routine care. No new exercise program or treatment will be given as part of this retrospective study.
Detailed description
Pelvic floor muscles support the bladder, bowel, and reproductive organs and play an important role in maintaining pelvic floor function during pregnancy. Pregnancy can place increased demands on these muscles because of changes in body weight, posture, hormonal changes, and pressure on the pelvic floor. Exercise during pregnancy may help maintain pelvic floor muscle function. Hydrotherapy provides exercise in water, where buoyancy can reduce the load on the body and may allow pregnant women to exercise with greater comfort. Land-based exercise is another commonly used approach for maintaining physical function during pregnancy. However, it is not clear whether hydrotherapy and land-based exercise are associated with different levels of pelvic floor muscle endurance. This retrospective study will review existing clinical records of pregnant women who participated in hydrotherapy or land-based exercise. The researchers will compare the available pelvic floor muscle assessment findings between the two groups to determine whether pelvic floor muscle endurance differs between the exercise approaches. The findings may provide information about the potential role of hydrotherapy and land-based exercise in maintaining pelvic floor muscle function during pregnancy. The results may also help physiotherapists make informed decisions when selecting exercise approaches for pregnant women.
Interventions
OTHERHydrotherapy-Based Pelvic Floor Muscle Training
A structured hydrotherapy-based pelvic floor muscle training program conducted in a heated indoor therapy pool. Sessions were performed for 30 minutes, three times per week for six weeks, under the supervision of a trained physiotherapist. The water temperature was maintained at 32°C-34°C. Each session included warm-up and diaphragmatic breathing, pelvic floor muscle activation in supported buoyant positions, dynamic aquatic strengthening, and cool-down. Pelvic floor contractions were performed using the "squeeze and lift" technique, with three sets of 10 contractions held for five seconds. Aquatic exercises included water walking, hip movements, side leg raises, and supported squats using flotation devices or light aquatic equipment. Sessions concluded with stretching, relaxation, and breathing exercises.
OTHERLand Based Pelvic Floor Muscle Training
A structured land-based pelvic floor muscle training program conducted in a clinical exercise setting. Sessions were performed for 30 minutes, three times per week for six weeks, under the supervision of a trained physiotherapist. Each session included warm-up and diaphragmatic breathing, pelvic floor muscle activation, dynamic land-based strengthening, and cool-down. Pelvic floor contractions were performed using the "squeeze and lift" technique, with three sets of 10 contractions held for five seconds. Land-based exercises included walking, supported squats, hip movements, side leg raises, and functional strengthening exercises with controlled breathing and postural alignment. Sessions concluded with stretching, relaxation, and breathing exercises.
Sponsors
Saveetha University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* Pregnant women aged 20-35 years, singleton pregnancy confirmed by ultrasound, gestational age between 18 and 32 weeks (second to early third trimester), absence of obstetric complications such as placenta previa, gestational diabetes or preeclampsia medical clearance from an obstetrician to participate in hydrotherapy and moderate physical activity, ability to understand and follow instructions, willingness to participate in regular exercise sessions and attend follow-up assessments for 6 weeks.
Exclusion criteria
* Age below 20 years or above 35 years, gestational age outside the 18-32week range, multiple pregnancy, obstetric complications such as placenta previa, uncontrolled gestational diabetes or pregnancy-induced hypertension, open wounds or infections contraindicating hydrotherapy, musculoskeletal conditions limiting safe participation in aquatic exercise, history of cardiovascular or respiratory disorders, fear of water or discomfort in aquatic environments, inability to complete follow-up evaluations or refusal to participate in the intervention period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pelvic Floor Muscle Endurance measured using Perineometer | Baseline (Week 0), Week 3, Week 6 | Pelvic floor muscle endurance will be assessed using a perineometer, which measures the intravaginal pressure generated during voluntary pelvic floor muscle contractions. Participants will be instructed to perform sustained pelvic floor muscle contractions, and the pressure generated will be recorded in centimeters of water (cmH₂O). The perineometer provides an objective measure of pelvic floor muscle function and endurance. Measurements will be recorded at each assessment time point and analyzed as changes within and between the hydrotherapy-based pelvic floor muscle training and land-based pelvic floor muscle training groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pelvic Floor Muscle Strength measured using Modified Oxford Grading Scale | Baseline (Week 0), Week 3, Week 6 | Pelvic floor muscle strength will be assessed using the Modified Oxford Grading Scale through digital vaginal palpation. Muscle strength will be graded from 0 to 5, with 0 indicating no palpable contraction and 5 indicating a strong contraction against resistance. The MOGS score will be recorded at each assessment time point and analyzed to determine changes in pelvic floor muscle strength within and between the hydrotherapy-based pelvic floor muscle training and land-based pelvic floor muscle training groups. |
| Change in Urinary Incontinence Severity measured using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form | Baseline (Week 0), Week 3, Week 6 | Urinary incontinence severity will be assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. The questionnaire assesses the frequency and severity of urinary leakage and its impact on everyday life. The total score will be recorded at each assessment time point, with higher scores indicating greater severity and impact of urinary incontinence. Changes in scores will be analyzed within and between the hydrotherapy-based pelvic floor muscle training and land-based pelvic floor muscle training groups. |
Countries
India
Contacts
STUDY_DIRECTORShenbaga Sundaram Subramanian
Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences (SIMATS)
Outcome results
None listed