Dynamic Neuromuscular Stabilization Exercises in Women With Urinary Incontinence

Last updated: May 29, 2025
Sponsor: Izmir University of Economics
Overall Status: Active - Recruiting

Phase

N/A

Condition

Urinary Incontinence

Enuresis

Treatment

Pelvic floor muscle training

Dynamic neuromuscular stabilization

Clinical Study ID

NCT07009249
SYY_IEU_5
  • Ages 18-62
  • Female

Study Summary

Stress urinary incontinence (SUI) is defined by the International Continence Society as the complaint of involuntary leakage of urine during physical exertion, including sports activities, or during sneezing or coughing. In continent women, an automatic response-namely, a reflex pelvic floor muscle (PFM) contraction, also known as pre-contraction-occurs either prior to or during physical exertion. Although there is strong evidence supporting the effectiveness of pelvic floor muscle training (PFMT) in the treatment of SUI, there has been a growing interest in exploring alternative exercise-based interventions.

Dynamic Neuromuscular Stabilization (DNS) is a manual and rehabilitative approach developed by Professor Pavel Kolar. It is grounded in the scientific principles of developmental kinesiology and aims to optimize the function of the movement system. Currently, DNS is successfully employed in the rehabilitation of various neurological, musculoskeletal, pediatric, and sports-related injuries. DNS incorporates the subconscious and synergistic activation of the deep core muscles responsible for intra-abdominal pressure (IAP) regulation and spinal stability-namely, the diaphragm, transversus abdominis, multifidus, and pelvic floor muscles-as well as the global musculature.

Considering the potential mechanisms of DNS, we hypothesize that DNS exercises, through IAP regulation directed toward the pelvic cavity and contributing to stabilization, could serve as an effective and innovative approach for women with SUI.

The hypotheses of this study are as follows:

H1.1: DNS is as effective as PFMT in reducing urinary symptoms in women with SUI.

H1.2: DNS is as effective as PFMT in improving PFM function in women with SUI.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Female gender,

  • Voluntary participation in the study,

  • Aged between 18 and 62 years,

  • Ability to read and write in Turkish,

  • No mental disorders that would impair cooperation or comprehension,

  • Complaint of stress urinary incontinence (SUI) or stress-predominant mixed urinaryincontinence.

Exclusion

Exclusion Criteria:

  • Prior history of pelvic floor muscle training,

  • Presence of any neurological disorder,

  • Pelvic organ prolapse stage II or higher,

  • Presence of fecal incontinence,

  • Pregnancy,

  • Lower extremity conditions that may affect pelvic alignment (e.g., leg lengthdiscrepancy, total hip arthroplasty),

  • Active lower urinary tract infection,

  • Presence of respiratory disorders such as chronic obstructive pulmonary disease orasthma,

  • History of hysterectomy.

Study Design

Total Participants: 62
Treatment Group(s): 2
Primary Treatment: Pelvic floor muscle training
Phase:
Study Start date:
May 21, 2025
Estimated Completion Date:
February 01, 2026

Connect with a study center

  • Izmir University of Economics

    İzmir, 35330
    Turkey

    Active - Recruiting

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