Trampoline-Induced Changes in Pelvic Structure and Continence

Overview

The goal of this clinical trial is to evaluate whether a short bout of high-intensity trampoline jumping induces urinary leakage or measurable changes in pelvic floor morphology in active females aged 18-40 who do not report symptoms of urinary incontinence. The main questions it aims to answer are: Hypothesis 1: Does a single 10-minute trampoline protocol result in acute changes in pelvic floor structure, including bladder neck position, levator plate length, and/or posterior urethrovesical angle (PUVA)? Hypothesis 2: Do participants report any urinary leakage during the jumping protocol, despite being asymptomatic at baseline? Hypothesis 3: Do pelvic morphology changes recover within 30 minutes post-jumping, or do alterations persist? Researchers will perform within-subject comparisons at multiple time points (pre-jump, immediately post-jump, and 30 minutes post-jump) using transperineal ultrasound imaging to assess structural changes. Participants will: * Attend one laboratory visit * Complete baseline pelvic health questionnaires (ICIQ-UI Short Form and PFD Sentinel). * Undergo 2D transperineal ultrasound imaging in the standing position at rest, immediately post-jumping, and 30 minutes post-jumping. * Perform a 10-minute high-intensity jumping protocol on a mini-trampoline, while heart rate and perceived exertion are monitored. * Verbally report any urine leakage during jumping using standardized descriptors.

Urinary incontinence (UI) has traditionally been associated with postpartum or older women; however, growing evidence highlights its prevalence among young, physically active females - even in those without a history of pelvic floor dysfunction or childbirth. High-impact physical activities such as running, jumping, and trampolining have been shown to increase intra-abdominal pressure, placing acute mechanical stress on the pelvic floor and potentially contributing to urinary leakage. While the relationship between high-impact exercise and stress urinary incontinence (SUI) has been explored in terms of prevalence, less is known about the acute, real-time mechanical effects of impact loading on pelvic floor structures in asymptomatic individuals. This study aims to investigate whether a 10-minute high-intensity trampoline protocol induces measurable changes in pelvic morphology - specifically in bladder neck position, levator plate length, and/or posterior urethrovesical angle (PUVA) - in physically active females aged 18-40 who do not report urinary incontinence symptoms. These anatomical parameters are indicators of pelvic floor support and dysfunction, and their change under load may signal early mechanical strain on the pelvic floor. Participants will undergo a single study session involving a baseline transperineal ultrasound assessment, a 10-minute jumping bout, and follow-up ultrasound assessments immediately, and 30 minutes post-exercise. Urinary leakage is monitored during jumping via verbal self-report every 2 minutes, with descriptive classifications such as "drops," "squirt," or "gush." Jumping intensity is tracked using the Borg RPE scale and heart rate monitoring via Apple Watch, which has demonstrated acceptable validity for exercise heart rate tracking. A repeated-measures design will be used to assess within-subject changes in pelvic morphology, with participants serving as their own control across time points. Data will be analyzed using repeated-measures ANOVA to determine statistically significant changes, with Cohen's d effect sizes calculated to assess magnitude of effect. Leakage data will be reported descriptively. Ultimately, this study will generate foundational data on the immediate biomechanical response of the pelvic floor to high-impact activity. These findings may help identify early indicators of pelvic floor strain, even in women without symptomatic UI, and could inform future screening and prevention strategies for active female populations.