INTRODUCTION

Stress urinary incontinence (SUI) is a common issue among women, affecting not only their physical health but also their mental and social well-being. SUI occurs when there is involuntary urine leakage due to increased intra-abdominal pressure. In SUI, the pelvic floor muscles play a crucial role. These muscles comprise a group of tissues that support the internal pelvic organs, including the bladder, uterus, and intestines, and regulate functions such as urinary and fecal control. The strength and health of the pelvic floor muscles can prevent or reduce the severity of urinary incontinence. Weakness in these muscles often results from multiple cumulative factors over a woman's lifetime. Walking and balance are among the most important components of daily mobility, and pelvic floor muscle weakness can significantly impact them. The pelvic floor muscles stabilize the body's core and collaborate with other muscle groups to maintain balance and walking ability. The pelvic floor muscles play a key role in maintaining balance and walking by stabilizing the center of gravity and working with other muscle groups. Weakness of the pelvic floor muscles increases the likelihood of falling and impairs the ability to perform precise movements. This problem is more evident, especially in older women who are more prone to general muscle weakness. Loss of pelvic floor muscle strength can limit walking, lead to a fear of daily activities, and cause social isolation. Urinary incontinence, especially in women, has a profound impact on different aspects of their quality of life. Physically, this condition causes limitations in daily activities, avoiding trainning, and even changes in nutritional habits to reduce the frequency of urination. Psychologically, the feeling of shame, anxiety, and reduced self-confidence caused by the fear of unwanted urination causes severe psychological pressure on a person. Accordingly, the present work aimed to investigate the effects of an eight-week pelvic floor muscle training program on urinary incontinence, quality of life, and walking ability in women with SUI.
METHODS
This quasi-experimental study employed a pretest-posttest design with a control group. The statistical population consisted of women aged 30 to 65 with SUI in Najafabad city in Iran. Among the statistical population, after screening and definitive diagnosis by a gynecologist and obstetrician, 30 people were selected voluntarily and were available. The selected women were divided by simple randomization into two equal experimental and control groups )n=15). Single-blinded masking was applied to the selected participants. Ethical compliance was confirmed by obtaining the ethical code. Participants in both groups initially completed pretests, including the Questionnaire for Urinary Incontinence Diagnosis (QUID), Urogenital Distress Inventory (UDI), and Incontinence Quality of Life Questionnaire (IQOL), which are specific to these patients. Their pelvic floor muscle strength was recorded with a vaginal probe. The subjects' walking and balance were assessed and recorded using the Timed Up and Go Test and the Four Square Step Test. The experimental group then began an eight-week supervised training program, performing pelvic floor training three times a week for 30–45 minutes per session. During this time, the control group continued with their normal routine. After eight weeks, all participants were re-evaluated using the same tools. The data were analyzed using an independent t-test and analysis of covariance (ANCOVA (at a significance level of 0.05 and using SPSS (version 27) software.
RESULTS
According to the results of the pre-test, all the variables studied affected the post-test results (p=0.001). After removing the pre-test effect, a significant difference was found between the two experimental and control groups in the post-test results for all research variables (p=0.001). According to the results, the effect size of the UID, complete contraction of the pelvic floor muscles, and complete relaxation of the pelvic floor muscles had the highest values ​​with effect size coefficients of 0.73, 0.71, and 0.62, respectively, which indicates that these factors accounted for the highest amount of total variance among other variables and were among the main factors of the difference between the two groups among other variables.
CONCLUSION
Eight weeks of pelvic floor muscle training in the experimental group increased complete pelvic floor muscle contraction ability by 27% and reduced urinary incontinence by 10.54% based on the QUID and 34.55% based on the UDI. Motor performance improved by 9.5% in the TUG test and 8.5% in the FSST, while quality of life improved by nearly 10% (9.79). Overall, the training program reduced urinary incontinence, enhanced pelvic floor muscle strength and walking performance, and improved the quality of life in women with SUI. Therefore, the use of this pelvic floor muscle training program is recommended for women with SUI.
Ethical Considerations
Compliance with ethical guidelines
The present work was extracted from a master's thesis submitted by Hanieh Moeini with ethics code IR.SKU.REC1402.013.
Funding
There was no funding support for this work.
Authors’ ContributionThe authors contributed equally to the conceptualization and writing of the article. All of the authors approved the content of the manuscript and agreed on all aspects of the work.
Conflict of Interest
The authors declared that there is no conflict of interest.
Acknowledgments
We are grateful to all the individuals who provided scientific consulting for this research.