Posturography Rehabilitation and Pelvic Floor Training on Urinary Incontinence in Women

Effect of Lumbopelvic Rehabilitation Using Posturography Combined With Pelvic Floor Training on Urinary Incontinence in Women

The goal of this clinical trial is to evaluate whether lumbopelvic postural rehabilitation combined with pelvic floor muscle training (PFMT) is more effective than PFMT alone in women with urinary incontinence. The main questions it aims to answer are:

• Does the addition of lumbopelvic postural rehabilitation improve the severity of urinary incontinence as measured by the ICIQ-UI-SF questionnaire?
• Does it improve urinary symptom profile, pelvic floor muscle strength, patient-reported overall improvement, and quality of life compared to PFMT alone?

Participants will be randomly assigned to one of two groups:

• Experimental group (Group A): PFMT (3 sessions/week) plus lumbopelvic postural rehabilitation (2 sessions/week) for 12 weeks.
• Control group (Group B): PFMT alone (3 sessions/week) for 12 weeks. Participants will perform pelvic floor exercises in supine and seated positions, with supervised sessions at the hospital and home exercises. Postural rehabilitation includes stability and mobility exercises for the lumbopelvic region using Posturography. Outcomes will be assessed at baseline, at 6 weeks, and at 12 weeks.

Inclusion Criteria:

• Female participants aged between 18 and 65 years
• Presence of clinical signs of urinary incontinence (stress urinary incontinence and/or urge urinary incontinence and/or mixed urinary incontinence) diagnosed according to the International Continence Society (ICS) terminology
• USP (urinary symptom profile) scores for stress urinary incontinence and/or overactive bladder ≥ 1
• Normal neuro-perineal examination
• Written informed consent provided prior to participation in the study

Exclusion Criteria:

• Known detrusor overactivity or reduced bladder compliance of neurological origin
• Associated voiding dysfunction, defined as a Urinary Symptom Profile (USP) dysuria subscale score ≥ 1
• Known organic or morphological pathology of the lower urinary tract
• Pelvic organ prolapse grade II or higher according to the Pelvic Organ Prolapse Quantification system (POP-Q)
• Current urinary tract infection or vaginal infection
• Cognitive or visual impairments that may interfere with understanding or performing the exercise program
• Pregnant women or women within 10 months postpartum
• Anticholinergic medication use or hormone replacement therapy within the last 6 months
• Recent pelvic or abdominal surgery within the last 6 months