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.
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
Pregnancy
Childbirth within the previous 6 weeks
Severe pelvic organ prolapse
Active vaginal or urinary tract infection
Parallel
Conventional Pelvic Floor Muscle Training
Other interventionParticipants will receive conventional pelvic floor muscle training based on standardized pelvic floor physiotherapy principles. Exercises will be performed for 12 weeks, at least three days per week, including one supervised session and two home-based sessions.
Pelvic Floor and Core Muscle Co-activation Training
Other interventionParticipants will receive pelvic floor muscle training combined with co-activation exercises targeting core muscles. The program will be conducted for 12 weeks with the same frequency and supervision structure as the control group.
International Consultation on Incontinence Questionnaire
This is a brief patient-reported questionnaire used to assess the frequency, severity, and impact of urinary incontinence on quality of life. Minimum Score: 0 Maximum Score: 21 Interpretation: Higher scores indicate worse symptoms and a greater impact on quality of life. Breakdown: The score is the sum of three items: frequency (0-5), amount (0-6), and interference with everyday life (0-10).
PERFECT scheme
This is used to evaluate Pelvic Floor Muscle Function. It evaluates four components: Power, Endurance, Repetitions, and Fast contractions. Higher scores indicate better muscle function
Surface electromyography
This is used to evaluate Core and Pelvic Floor Muscle Activation
Urogenital Distress Inventory (UDI-6)
This questionnaire assesses the degree of bother associated with specific urogenital symptoms (e.g., frequent urination, leakage). Minimum Score: 0 Maximum Score: 100 (Standardized Scale) Interpretation: Higher scores indicate worse quality of life (higher distress). Calculation: There are 6 items. Each is rated 0 (Not at all) to 3 (Greatly). The average score of the items is calculated and then multiplied by 33.33 to convert it to a 0-100 scale.
the Incontinence Impact Questionnaire (IIQ-7)
This questionnaire measures the impact of urinary incontinence on activities, roles, and emotional health. Minimum Score: 0 Maximum Score: 100 (Standardized Scale) Interpretation: Higher scores indicate worse quality of life (greater negative impact). Calculation: There are 7 items. Each is rated 0 (Not at all) to 3 (Greatly). Like the UDI-6, the average of the item scores is multiplied by 33.33 to obtain the final 0-100 score.
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