Synchronized Core-Pelvic Floor Activation in Urinary Incontinence

Synchronized Activation of Core and Pelvic Floor Muscles: A More Effective Strategy for Urinary Incontinence?

This study aims to investigate whether co-activation of the pelvic floor and core muscles improves treatment outcomes in individuals with urinary incontinence. Participants diagnosed with stress, or mixed urinary incontinence will undergo a 12-week pelvic floor physiotherapy program, with or without additional core muscle co-activation exercises. Changes in urinary incontinence severity, pelvic floor muscle function, core muscle activation, and quality of life will be evaluated.

Urinary incontinence is a prevalent condition that negatively affects quality of life and functional independence. Pelvic floor muscle training (PFMT) is recommended as a first-line conservative treatment. Recent evidence suggests that coordinated activation of the pelvic floor muscles with core muscles, including the transversus abdominis and multifidus, may enhance treatment effectiveness.

This randomized controlled study will include women aged 18-65 years diagnosed with stress or mixed urinary incontinence. Eligible participants will be randomly allocated to one of two groups: a conventional pelvic floor muscle training group (control group) or a pelvic floor muscle training plus core muscle co-activation group (intervention group).

Both groups will participate in a 12-week exercise program performed at least three days per week, including one supervised session and two home-based sessions weekly. Outcome measures will be assessed at baseline and after completion of the intervention. Primary outcomes include urinary incontinence severity, while secondary outcomes include pelvic floor muscle function, core muscle activation assessed by surface electromyography, and quality of life.

Inclusion Criteria:

• Aged between 18 and 65 years
• Diagnosed with stress, urge, or mixed urinary incontinence
• Pelvic floor muscle strength grade ≥ 3 according to the Modified Oxford Scale
• At least one episode of urinary leakage within the last month

Exclusion Criteria:

• Pregnancy
• Childbirth within the previous 6 weeks
• Severe pelvic organ prolapse
• Active vaginal or urinary tract infection
• Presence of neurological or psychiatric disorders
• Malignancy
• Inability to cooperate with assessments or interventions