Study participants will be randomised into 2 groups. Group 1: 1st assessment + 6 weeks of Global Postural Reeducation training plus standard pelvic floor exercises + 2nd assessment + 6 weeks of Global Postural Reeducation training plus standard pelvic floor exercises + 3rd assessment 2nd Group: 1st assessment + 6 weeks of Global Postural Reeducation training plus involuntary reflexive pelvic floor exercises + 2nd assessment + 6 weeks of Global Postural Reeducation training plus involuntary reflexive pelvic floor exercises + 3rd assessment
Voluntary participants who agreed to participate in the study will be randomised into 2 groups of 36 people each (standard pelvic floor exercises and involuntary reflexive pelvic floor exercises) with the "Research Randomizer" programme (https://www.randomizer.org/). Group 1 (36 people) will receive Global Postural Reeducation training plus standard pelvic floor exercises for 12 weeks, 7 days a week (Total 84 sessions, 15 sessions face to face, 69 sessions home programme). Even numbers will be included in the 2nd group (36 people) and involuntary reflexive pelvic floor exercises will be given in addition to Global Postural Reeducation training for 12 weeks, 7 days a week (Total 84 sessions, 15 sessions face-to-face, 69 sessions home programme). In the study, detailed pelvic floor training will be given to both groups and the same assessments will be made on the pelvic floor muscles. After the initial assessments are completed, both groups will be given a total of 42 sessions of standard and involuntary reflexive pelvic floor exercises for 6 weeks (7 days a week). Participants in both groups will be evaluated at the end of 6 weeks and the remaining 6 weeks exercise programme will be given according to the arranged programme. At the end of the 12th week, the participants will be evaluated again. Group 1: 1st assessment + 6 weeks of Global Postural Reeducation training plus standard pelvic floor exercises + 2nd assessment + 6 weeks of Global Postural Reeducation training plus standard pelvic floor exercises + 3rd assessment 2nd Group: 1st assessment + 6 weeks of Global Postural Reeducation training plus involuntary reflexive pelvic floor exercises + 2nd assessment + 6 weeks of Global Postural Reeducation training plus involuntary reflexive pelvic floor exercises + 3rd assessment
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
Pelvic floor muscle exercises will be given as 2 separate exercises including fast and slow contractions. For fast contractions, participants will be asked to contract their pelvic floor muscles strongly, hold them contracted for 5 seconds, and then relax them. For slow contractions, participants will be asked to gradually contract the pelvic floor muscles, hold them at maximum contraction for 5 seconds, and relax them gradually. Participants will be asked to perform 10 slow contractions after every 10 fast contractions. The aim is to train strength, coordination, endurance, and symmetry of pelvic floor muscles, motor learning and control, dynamic lumbopelvic stability, pelvic floor, and abdominal co-contraction. Every day, 10 fast, and 10 slow contractions with a total of 20 repetitions will be applied without changing the number by modifying the exercises every week. It will be applied for a total of 12 weeks.
Reflexive exercises (jump, squat jump, etc.) with 20 repetitions per day will be applied to the participants for 12 weeks with modifications every week.
Bandırma Onyedi Eylül University
Bandırma, Balıkesir, Turkey (Türkiye)
Pelvic Floor Distress Inventory-PFDI-20
The inventory consists of 3 sub-dimensions and contains 20 questions in total. The number of questions of each sub-dimension is indicated next to the name of that sub-dimension (For example; KRADE-8 contains 8 questions in total. The answer option of each question is divided into two as no and yes. Yes option is graded from Unimportant to Very. No=0, and the level of the answer of Yes corresponds to Insignificant=1, Less=1, Less=2, Moderate=3, Very=4 points. The score calculation system of the inventory is as follows; the average score of each sub-dimension is multiplied by 25. The number of points of 3 sub-dimensions is summed and a number between 0-300 points is obtained. The higher the score, the more serious the individual's problems are.
Time frame: Baseline
Pelvic Floor Distress Inventory-PFDI-20
The inventory consists of 3 sub-dimensions and contains 20 questions in total. The number of questions of each sub-dimension is indicated next to the name of that sub-dimension (For example; KRADE-8 contains 8 questions in total. The answer option of each question is divided into two as no and yes. Yes option is graded from Unimportant to Very. No=0, and the level of the answer of Yes corresponds to Insignificant=1, Less=1, Less=2, Moderate=3, Very=4 points. The score calculation system of the inventory is as follows; the average score of each sub-dimension is multiplied by 25. The number of points of 3 sub-dimensions is summed and a number between 0-300 points is obtained. The higher the score, the more serious the individual's problems are.
Time frame: 6 Weeks Later
Pelvic Floor Distress Inventory-PFDI-20
The inventory consists of 3 sub-dimensions and contains 20 questions in total. The number of questions of each sub-dimension is indicated next to the name of that sub-dimension (For example; KRADE-8 contains 8 questions in total. The answer option of each question is divided into two as no and yes. Yes option is graded from Unimportant to Very. No=0, and the level of the answer of Yes corresponds to Insignificant=1, Less=1, Less=2, Moderate=3, Very=4 points. The score calculation system of the inventory is as follows; the average score of each sub-dimension is multiplied by 25. The number of points of 3 sub-dimensions is summed and a number between 0-300 points is obtained. The higher the score, the more serious the individual's problems are.
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PREVENTION
Masking
SINGLE
Enrollment
36
Time frame: 12 Weeks Later
The female sexual function index (FSFI)
This scale assesses six dimensions of sexual function: sexual desire (first 2 questions), sexual arousal (questions 3-6), lubrication (questions 7-10), orgasm (questions 11-13), satisfaction (questions 14-16) and pain or discomfort (e.g. pain associated with vaginal penetration, questions 17-19). The highest total raw score that can be obtained in this scale is 95.0 and the lowest raw score is 4.0. Factor loadings used for scoring the whole scale were determined as 0.6 for sexual desire, 0.3 for sexual arousal and lubrication, 0.4 for orgasm, satisfaction and pain/discomfort. After multiplication by factor loadings, the highest score is 36.0 and the lowest score is 2.0. Total score \>22.7 indicates normal sexual function and ≤ 22.7 indicates sexual dysfunction.
Time frame: Baseline
The female sexual function index (FSFI)
This scale assesses six dimensions of sexual function: sexual desire (first 2 questions), sexual arousal (questions 3-6), lubrication (questions 7-10), orgasm (questions 11-13), satisfaction (questions 14-16) and pain or discomfort (e.g. pain associated with vaginal penetration, questions 17-19). The highest total raw score that can be obtained in this scale is 95.0 and the lowest raw score is 4.0. Factor loadings used for scoring the whole scale were determined as 0.6 for sexual desire, 0.3 for sexual arousal and lubrication, 0.4 for orgasm, satisfaction and pain/discomfort. After multiplication by factor loadings, the highest score is 36.0 and the lowest score is 2.0. Total score \>22.7 indicates normal sexual function and ≤ 22.7 indicates sexual dysfunction.
Time frame: 6 Weeks Later
The female sexual function index (FSFI)
This scale assesses six dimensions of sexual function: sexual desire (first 2 questions), sexual arousal (questions 3-6), lubrication (questions 7-10), orgasm (questions 11-13), satisfaction (questions 14-16) and pain or discomfort (e.g. pain associated with vaginal penetration, questions 17-19). The highest total raw score that can be obtained in this scale is 95.0 and the lowest raw score is 4.0. Factor loadings used for scoring the whole scale were determined as 0.6 for sexual desire, 0.3 for sexual arousal and lubrication, 0.4 for orgasm, satisfaction and pain/discomfort. After multiplication by factor loadings, the highest score is 36.0 and the lowest score is 2.0. Total score \>22.7 indicates normal sexual function and ≤ 22.7 indicates sexual dysfunction.
Time frame: 12 Weeks Later
Global Pelvic Floor Bother Questionnaire
The scale consists of 9 questions in total. The questions were graded as "yes" or "no" (0) according to whether they had the complaint or not, and if they answered yes, how much the complaint bothered them was graded as "not at all" (1), "very little" (2), "a little" (3), "quite" (4), "very much" (5). Each question was given a score between 1 and 5. The scoring system gives the same weight to each question. The total score is between 0 and 45. For a score between 0 and 100, the total score is averaged and multiplied by 20. A high score indicates a high number of complaints.
Time frame: Baseline
Global Pelvic Floor Bother Questionnaire
The scale consists of 9 questions in total. The questions were graded as "yes" or "no" (0) according to whether they had the complaint or not, and if they answered yes, how much the complaint bothered them was graded as "not at all" (1), "very little" (2), "a little" (3), "quite" (4), "very much" (5). Each question was given a score between 1 and 5. The scoring system gives the same weight to each question. The total score is between 0 and 45. For a score between 0 and 100, the total score is averaged and multiplied by 20. A high score indicates a high number of complaints.
Time frame: 6 Weeks Later
Global Pelvic Floor Bother Questionnaire
The scale consists of 9 questions in total. The questions were graded as "yes" or "no" (0) according to whether they had the complaint or not, and if they answered yes, how much the complaint bothered them was graded as "not at all" (1), "very little" (2), "a little" (3), "quite" (4), "very much" (5). Each question was given a score between 1 and 5. The scoring system gives the same weight to each question. The total score is between 0 and 45. For a score between 0 and 100, the total score is averaged and multiplied by 20. A high score indicates a high number of complaints.
Time frame: 12 Weeks Later
Overactive Bladder Questionnaire (OAB-V8)
The OAB-V8 consists of the first 8 questions of the OAB-q and has been proposed as an overactive bladder screening and awareness test.
Time frame: Baseline
Overactive Bladder Questionnaire (OAB-V8)
The OAB-V8 consists of the first 8 questions of the OAB-q and has been proposed as an overactive bladder screening and awareness test.
Time frame: 6 Weeks Later
Overactive Bladder Questionnaire (OAB-V8)
The OAB-V8 consists of the first 8 questions of the OAB-q and has been proposed as an overactive bladder screening and awareness test.
Time frame: 12 Weeks Later
Pelvic Muscle Assessment
The PERFECT Scale can be used to assess voluntary contraction strength (P), endurance (E), slow-twitch muscle fibre performance (R), fast-twitch muscle fibre performance (F), pelvic floor muscle contraction pattern (E), transversus abdominus muscle cocontraction (C) and involuntary contraction in response to increased intra-abdominal pressure (T).
Time frame: Baseline
Pelvic Muscle Assessment
The PERFECT Scale can be used to assess voluntary contraction strength (P), endurance (E), slow-twitch muscle fibre performance (R), fast-twitch muscle fibre performance (F), pelvic floor muscle contraction pattern (E), transversus abdominus muscle cocontraction (C) and involuntary contraction in response to increased intra-abdominal pressure (T).
Time frame: 6 Weeks Later
Pelvic Muscle Assessment
The PERFECT Scale can be used to assess voluntary contraction strength (P), endurance (E), slow-twitch muscle fibre performance (R), fast-twitch muscle fibre performance (F), pelvic floor muscle contraction pattern (E), transversus abdominus muscle cocontraction (C) and involuntary contraction in response to increased intra-abdominal pressure (T).
Time frame: 12 Weeks Later
Waist/ Hip Ratio
Waist-to-hip ratio (WHR) is the waist circumference divided by the hip circumference
Time frame: Baseline
Waist/ Hip Ratio
Waist-to-hip ratio (WHR) is the waist circumference divided by the hip circumference
Time frame: 6 Weeks Later
Waist/ Hip Ratio
Waist-to-hip ratio (WHR) is the waist circumference divided by the hip circumference
Time frame: 12 Weeks Later
Estimating body fat
This technique is based on the compression of the skin fold to measure the skin and the subcutaneous fat layer beneath it. To improve accuracy, multiple readings are taken in each body region and these readings are averaged and evaluated. The most common application is to measure skinfold thickness from three or four areas of the body and estimate the percentage of BF using prognostic equations.
Time frame: Baseline
Estimating body fat
This technique is based on the compression of the skin fold to measure the skin and the subcutaneous fat layer beneath it. To improve accuracy, multiple readings are taken in each body region and these readings are averaged and evaluated. The most common application is to measure skinfold thickness from three or four areas of the body and estimate the percentage of BF using prognostic equations.
Time frame: 6 Weeks Later
Estimating body fat
This technique is based on the compression of the skin fold to measure the skin and the subcutaneous fat layer beneath it. To improve accuracy, multiple readings are taken in each body region and these readings are averaged and evaluated. The most common application is to measure skinfold thickness from three or four areas of the body and estimate the percentage of BF using prognostic equations.
Time frame: 12 Weeks Later
ICIQ-SF: International Consultation on Incontinence Questionnaire-Short Form
The International Consultation on Incontinence Questionaire Short Form (ICIQ-SF), which has Turkish validity and reliability, will be used to question the type, frequency, amount and effects of urinary incontinence on daily life.
Time frame: Baseline
ICIQ-SF: International Consultation on Incontinence Questionnaire-Short Form
The International Consultation on Incontinence Questionaire Short Form (ICIQ-SF), which has Turkish validity and reliability, will be used to question the type, frequency, amount and effects of urinary incontinence on daily life.
Time frame: 6 Weeks Later
ICIQ-SF: International Consultation on Incontinence Questionnaire-Short Form
The International Consultation on Incontinence Questionaire Short Form (ICIQ-SF), which has Turkish validity and reliability, will be used to question the type, frequency, amount and effects of urinary incontinence on daily life.
Time frame: 12 Weeks Later