The purpose of this study was to determine the effect of spinal alignment on pelvic floor efficiency in nulliparous women.

Pelvic floor dysfunction (PFD) may extend beyond the pelvic region by inducing myofascial disturbances in anatomically distant structures connected through the myofascial network. Among these, low back pain (LBP) is one of the most frequently reported musculoskeletal conditions associated with PFD. This relationship is thought to arise from lumbopelvic instability and altered coordination of the core musculature. The pelvic floor muscles (PFMs), together with the transversus abdominis, diaphragm, and multifidus, form an integrated stabilizing system that contributes to spinal stability and postural control. Consequently, dysfunction of the transversus abdominis may compromise not only pelvic floor function but also overall lumbopelvic stability. Women with LBP have been shown to exhibit reduced PFM contraction strength despite preserved transversus abdominis activation, suggesting that impaired PFM function may play a more prominent role in the development of LBP than deficits in the abdominal muscles alone. Conversely, inadequate activation or endurance of the transversus abdominis has also been associated with impaired PFM function. Furthermore, altered movement patterns, dysfunctional breathing, and postural deviations can disrupt load transfer through the lumbopelvic region, thereby increasing the risk of PFD.

There is a dearth of knowledge regarding the effect of spinal alignment on pelvic floor efficiency in nulliparous women. This study, therefore, contributes valuable insights into a relatively unexplored area of nulliparous women's health. By assessing the pelvic floor muscles in nulliparous women with different spinal alignment patterns, including lordosis, kyphosis, and scoliosis, this study may enhance the well-being of nulliparous women, provide a more comprehensive approach to health improvement, help protect them from future pelvic floor dysfunction, and broaden the scope of physiotherapy in women's health.

Inclusion Criteria:

• Nulliparous women.
• Their ages will range from 25 to 35 years old.
• Their body mass index (BMI) will not exceed 29.9 Kg/m2.

Exclusion Criteria:

• Female with congenital spinal deformity.
• Female with a history of neuromuscular disease.
• Female Diagnosed with any systemic disease .
• Female with a history of malignancy and/or ongoing treatment.
• Female with a history of urogenital diseases and surgical history.
• Female with previous spinal surgery.
• Female with previous pregnancy .

The study population consisted of 80 nulliparous women aged 25-35 years with different spinal alignment patterns (thoracolumbar scoliosis, hyperlordosis, thoracic kyphosis, or normal spinal alignment). Participants were recruited from the outpatient orthopedic clinic of Gesr El Suez, Cairo, Egypt. Eligible participants had a body mass index (BMI) of <30 kg/m² and no history of pregnancy, spinal surgery, congenital spinal deformity, neuromuscular disorders, systemic diseases, malignancy, or urogenital disorders.