Ignite Creation Date:
2024-10-26 @ 3:42 PM
Last Modification Date:
2024-10-26 @ 3:42 PM
Study NCT ID:
NCT06627452
Status:
NOT_YET_RECRUITING
Last Update Posted:
None
First Post:
2024-10-02
Brief Title:
Effectiveness of DNS on Incontinence Severity Pelvic Floor Strength and QoL in Urinary Incontinence
Sponsor:
None
Organization:
None
Study Overview
Official Title:
The Effectiveness of Dynamic Neuromuscular Stabilization on Incontinence Severity Pelvic Floor Muscle Strength and Quality of Life in Women with Urinary Incontinence
Status:
NOT_YET_RECRUITING
Status Verified Date:
2024-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The aim of this study is to investigate the effects of Dynamic Neuromuscular Stabilization DNS Training on incontinence severity pelvic floor muscle strength and quality of life in women with Urinary Incontinence compared to Pelvic Floor Muscle Training PFMT The hypothesis of the study is that DNS Training will be at least as effective as PFMT in terms of its impact on incontinence severity pelvic floor muscle strength and quality of life in women with Urinary Incontinence A total of 52 women diagnosed with urinary incontinence will be included in the study Participants will be divided into two groups DNS and PFMT and will engage in the designated exercise program 5 days a week for a total of 12 weeks All participants will undergo an initial assessment before starting treatment and a final assessment will be conducted by the same physiotherapist after the treatment
Detailed Description:
Urinary incontinence UI is defined by the International Continence Society as involuntary leakage of urine and is a symptom that can objectively be demonstrated leading to social and hygienic problems UI negatively affects daily life activities perception of health status and mental and social well-being thereby reducing individuals39 health-related quality of life UI is commonly observed in women with a reported prevalence ranging from 25 to 45 There are three main types of urinary incontinence stress urinary incontinence urge urinary incontinence and mixed urinary incontinence The most commonly seen type stress urinary incontinence is defined as involuntary urine leakage due to a sudden increase in intra-abdominal pressure IAP during activities such as coughing sneezing exertion or physical activity without detrusor contraction It generally occurs after childbirth or during pregnancy Risk factors for stress urinary incontinence in women include a higher number of births age smoking lung disease and obesity One of the significant causes of UI is the weakness of the pelvic floor muscles PFM
It is known that the PFM helps stabilize the bladder neck and contributes to continence control by increasing intraurethral pressure The PFM also aids in stabilizing the lumbopelvic region core Studies show that the transverse abdominis TrA one of the most essential muscles providing core stabilization works synergistically with the PFM This co-activation has been reported to enhance pelvic stability and support urinary control modulating IAP and load transfer In this context in addition to PFM training stabilization exercises have begun to be included in treatment programs for patients with UI as a first-line treatment
Dynamic Neuromuscular Stabilization DNS is a neuromuscular and functional stabilization approach based on developmental kinesiology models utilizing the normal motor development process to assess and treat motor disorders The primary aim is to restore the physiological movement patterns defined by developmental kinesiology DNS provides stabilization of the spine and surrounding muscles during static and dynamic movements Deep spinal flexors and extensors multifidus diaphragm pelvic floor muscles and abdominal muscles are part of this system The co-contractions of these muscles increase IAP thereby aiding This also helps with stabilization DNS is based on the principle that the core muscle system works synergistically with various components When part of this system is weak or dysfunctional it can also affect the functioning of other core muscles DNS exercises focus on comprehensive activation and strengthening of the entire core muscle system rather than targeting individual muscles one by one In this context DNS training includes the development of pelvic floor muscles along with the improvement of core lumbopelvic stabilization
It is known that the strength of the pelvic floor muscles PFM decreases in women with UI and strengthening these muscles plays a crucial role in controlling incontinence However there are also studies reporting low stabilization in women with UI Considering that stress urinary incontinence occurs due to a sudden increase in intra-abdominal pressure during physical activity regulating IAP and improving stabilization could be more effective in controlling UI The DNS method which targets lumbopelvic stabilization along with PFM training and focuses on intra-abdominal pressure regulation has been shown to have positive effects on various neuromuscular disorders and postural dysfunctions There is only one pilot study in the literature investigating the effects of DNS training on women with UI This study reported that DNS improved PFM strength more than Kegel exercises Given this information it is hypothesized that DNS training may more effectively reduce the severity of urinary incontinence in women compared to PFM training Therefore this research aims to compare the effects of DNS training on urinary incontinence severity in women with urinary incontinence to PFM training
METHOD
The research will include young adult women who have been diagnosed with urinary incontinence and volunteered to participate Participants will be divided into two parallel groups 11 the dynamic neuromuscular stabilization DNS group and the pelvic floor muscle training PFMT group Our study will be conducted per the Helsinki Declaration and all participants will be informed about the research and provide written consent
Indıviduals will be randomly divided into the dynamic neuromuscular stabilization DNS and pelvic floor muscle training PFMT groups Randomization will be conducted using the Research Randomizer program and treatment programs will be determined based on this randomization The treatment program will be implemented by the same experienced physiotherapist who holds a training certificate in both DNS and PFMT Participants will be taught how to perform the exercises correctly and receive an exercise sheet containing exercises to perform at home as a guide
Dynamic Neuromuscular Stabilization Training Participants in this group will undergo Dynamic Neuromuscular Stabilization exercises The exercises will be performed with the physiotherapist twice a week while participants will practice at home three days a week with each session lasting approximately 30 minutes This program will continue for 12 weeks totaling five days of exercise per week The DNS therapist will manually and verbally instruct the participants on how to perform exercises in various developmental positions
Pelvic Floor Muscle Training Pelvic floor exercises will be taught to patients through vaginal palpation The exercises will be provided as a home program five days a week To increase adherence to the home exercises and encourage proper execution a PTKE schedule and a document demonstrating and explaining the pelvic floor exercises will be provided Exercise schedules will be checked weekly
Patients will be instructed to perform pelvic floor exercises in sets for approximately 30 minutes daily over a period of 12 weeks
It is known that the PFM helps stabilize the bladder neck and contributes to continence control by increasing intraurethral pressure The PFM also aids in stabilizing the lumbopelvic region core Studies show that the transverse abdominis TrA one of the most essential muscles providing core stabilization works synergistically with the PFM This co-activation has been reported to enhance pelvic stability and support urinary control modulating IAP and load transfer In this context in addition to PFM training stabilization exercises have begun to be included in treatment programs for patients with UI as a first-line treatment
Dynamic Neuromuscular Stabilization DNS is a neuromuscular and functional stabilization approach based on developmental kinesiology models utilizing the normal motor development process to assess and treat motor disorders The primary aim is to restore the physiological movement patterns defined by developmental kinesiology DNS provides stabilization of the spine and surrounding muscles during static and dynamic movements Deep spinal flexors and extensors multifidus diaphragm pelvic floor muscles and abdominal muscles are part of this system The co-contractions of these muscles increase IAP thereby aiding This also helps with stabilization DNS is based on the principle that the core muscle system works synergistically with various components When part of this system is weak or dysfunctional it can also affect the functioning of other core muscles DNS exercises focus on comprehensive activation and strengthening of the entire core muscle system rather than targeting individual muscles one by one In this context DNS training includes the development of pelvic floor muscles along with the improvement of core lumbopelvic stabilization
It is known that the strength of the pelvic floor muscles PFM decreases in women with UI and strengthening these muscles plays a crucial role in controlling incontinence However there are also studies reporting low stabilization in women with UI Considering that stress urinary incontinence occurs due to a sudden increase in intra-abdominal pressure during physical activity regulating IAP and improving stabilization could be more effective in controlling UI The DNS method which targets lumbopelvic stabilization along with PFM training and focuses on intra-abdominal pressure regulation has been shown to have positive effects on various neuromuscular disorders and postural dysfunctions There is only one pilot study in the literature investigating the effects of DNS training on women with UI This study reported that DNS improved PFM strength more than Kegel exercises Given this information it is hypothesized that DNS training may more effectively reduce the severity of urinary incontinence in women compared to PFM training Therefore this research aims to compare the effects of DNS training on urinary incontinence severity in women with urinary incontinence to PFM training
METHOD
The research will include young adult women who have been diagnosed with urinary incontinence and volunteered to participate Participants will be divided into two parallel groups 11 the dynamic neuromuscular stabilization DNS group and the pelvic floor muscle training PFMT group Our study will be conducted per the Helsinki Declaration and all participants will be informed about the research and provide written consent
Indıviduals will be randomly divided into the dynamic neuromuscular stabilization DNS and pelvic floor muscle training PFMT groups Randomization will be conducted using the Research Randomizer program and treatment programs will be determined based on this randomization The treatment program will be implemented by the same experienced physiotherapist who holds a training certificate in both DNS and PFMT Participants will be taught how to perform the exercises correctly and receive an exercise sheet containing exercises to perform at home as a guide
Dynamic Neuromuscular Stabilization Training Participants in this group will undergo Dynamic Neuromuscular Stabilization exercises The exercises will be performed with the physiotherapist twice a week while participants will practice at home three days a week with each session lasting approximately 30 minutes This program will continue for 12 weeks totaling five days of exercise per week The DNS therapist will manually and verbally instruct the participants on how to perform exercises in various developmental positions
Pelvic Floor Muscle Training Pelvic floor exercises will be taught to patients through vaginal palpation The exercises will be provided as a home program five days a week To increase adherence to the home exercises and encourage proper execution a PTKE schedule and a document demonstrating and explaining the pelvic floor exercises will be provided Exercise schedules will be checked weekly
Patients will be instructed to perform pelvic floor exercises in sets for approximately 30 minutes daily over a period of 12 weeks
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None