RecruitingNot ApplicableNCT07075900

Dynamic Neuromuscular Stabilization vs Pelvic Floor Muscle Training in Women With Stress Urinary Incontinence

Comparison of Effects of Dynamic Neuromuscular Stabilization Training and Pelvic Floor Muscle Training in Women With Stress Urinary Incontinence: A Randomized Controlled Trial

Sponsor

Izmir Katip Celebi University

Enrollment

51 participants

Start Date

Jul 16, 2025

Study Type

INTERVENTIONAL

Conditions

Quality of Life Pelvic Floor Muscle Training Stress Urinary Incontinence (SUI)Dynamic Neuromuscular Stabilization Urinary Symptoms Muscle Morphology

Summary

This randomized controlled trial aims to compare the pre- and post-treatment effects of Dynamic Neuromuscular Stabilization (DNS) training and Pelvic Floor Muscle Training (PFMT) on pelvic floor muscle function, pelvic floor morphometry, urinary symptoms, quality of life, sexual function, and physical activity levels in women with stress urinary incontinence (SUI). Participants diagnosed with SUI by a specialist physician will be randomly assigned to one of three groups: DNS, PFMT, or a control group. Both DNS and PFMT interventions will be delivered as 12-week home exercise programs, performed five days a week and at least three times per day. To support adherence, participants will use an exercise diary. In addition, participants in the DNS and PFMT groups will attend the clinic twice a week for supervised sessions led by a physiotherapist. The control group will receive a brochure containing lifestyle and bladder health recommendations but will not engage in any structured exercise program.

Eligibility

Sex: FEMALEMin Age: 18 YearsMax Age: 65 Years

Inclusion Criteria5

Female participants aged between 18 and 65 years
Diagnosed with stress urinary incontinence or stress-dominant mixed urinary incontinence by a specialist physician
Having the ability to voluntarily contract the pelvic floor muscles
Literate in Turkish
Willing and voluntarily consenting to participate in the study

Exclusion Criteria15

Pregnancy
Presence of urgency-predominant urinary incontinence symptoms or fecal incontinence
Inability to understand or cooperate with assessment procedures
Presence of any neurological or rheumatological disease
Severe cardiac or pulmonary disease
Uncontrolled diabetes mellitus or hypertension
Chronic liver and/or kidney failure
Advanced pelvic organ prolapse (greater than grade 2)
History of abdominal or pelvic surgery (including cesarean section) within the past year
History of spinal surgery
Current urinary tract infection
History of pelvic radiation therapy
Presence of spinal deformity
History of acute low back pain within the past 4-6 weeks
Receiving pelvic floor muscle training within the past three months

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Interventions

OTHERDynamic Neuromuscular Stabilization Training

According to the principles of Dynamic Neuromuscular Stabilization (DNS), proper activation of the integrated spinal stabilization system requires that the abdominal muscles expand not only in the caudal direction but also posteriorly and laterally.Therefore, firstly, the physiotherapist will assess the expansion of the entire abdominal wall and teach the patient to regulate intra-abdominal pressure through correct breathing techniques. During training and exercises, a belt will be used. Participants will be instructed to maintain abdominal expansion toward the belt during exercises performed in positions supported by proper alignment. A four-phase exercise protocol based on developmental kinesiology principles will be implemented for the DNS group, beginning with supine-position exercises appropriate for the 3-month developmental stage. They will be instructed to repeat the exercises at least three times per day.Patients will record their home exercise program using an exercise diary.

OTHERPelvic Floor Muscle Training

Participants in the PFMT group will undergo a structured pelvic floor muscle training program supervised by a physiotherapist. The training will include verbal and manual instructions to ensure correct identification and isolated activation of the pelvic floor muscles without compensatory movements from the gluteal, abdominal, or thigh muscles using a NeuroTrac Simplex EMG-Biofeedback device. The exercise protocol will consist of both slow and fast contractions, focusing on endurance, strength, and coordination. The exercises will be performed in various positions (e.g., supine, sitting, standing) and will gradually progress in intensity and complexity over time, following the principles of motor learning stages. They will be instructed to repeat the exercises at least three times per day. Patients will record their home exercise program using an exercise diary.