The POSH-Ex Study: Study Protocol for a Randomized Controlled Trial of a 12-Week Online Physiotherapy Intervention for Improving Postpartum Sexual Health.
4 affiliations
- 1Faculty of Health Sciences, University of Novo mesto, Na Loko 2, 8000 Novo Mesto, Slovenia.
- 2Department of Physiotherapy, University North, Trg dr. Žarka Dolinara 1, 48000 Koprivnica, Croatia.
- 3Department of Nephrology, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000 Ljubljana, Slovenia.
- 4Faculty of Sport, University of Ljubljana, Gortanova 22, 1000 Ljubljana, Slovenia.
Abstract
Background/objectives
Postpartum sexual dysfunction is common and multifactorial, yet structured physiotherapy interventions specifically targeting sexual function after childbirth remain insufficiently investigated. This study aims to evaluate the effectiveness of Postpartum Sexual Health Exercise (POSH-Ex), a standardized, multimodal, physiotherapist-led online therapeutic exercise programme designed to improve postpartum sexual function. We hypothesise that participants allocated to POSH-Ex will have a higher mean FSFI total score at 12 weeks than participants receiving usual postpartum care, after adjustment for baseline FSFI score.Methods
This randomized controlled trial will include 84 women recruited at 10-12 weeks postpartum and randomly allocated (1:1) to the POSH-Ex intervention or control group. The intervention will consist of a 12-week progressive programme delivered twice weekly in 60-min sessions, integrating pelvic floor muscle training, breathing and relaxation exercises, trunk stabilization, functional strengthening, flexibility, and movement re-education, while the control group will receive usual postpartum care and continue their usual activities without a study-specific exercise intervention. Outcomes will be assessed at baseline and after 12 weeks. Sexual function, assessed using the Female Sexual Function Index (FSFI), is the primary outcome; physical activity (IPAQ-SF), fatigue (FAS), and depressive symptoms (EPDS) are secondary outcomes. The primary analysis will compare FSFI scores at 12 weeks between groups using analysis of covariance (ANCOVA) adjusted for baseline FSFI. The trial was prospectively registered at ClinicalTrials.gov (NCT07747285).Conclusions
The POSH-Ex trial is designed to determine whether a structured, multimodal, physiotherapist-led online therapeutic exercise programme improves postpartum sexual function compared with usual postpartum care. If effective, POSH-Ex may inform the development of structured physiotherapy approaches that recognise sexual health as an integral component of comprehensive postpartum care.
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BibTeX
@article{degac2026poshex,
title = {{The POSH-Ex Study: Study Protocol for a Randomized Controlled Trial of a 12-Week Online Physiotherapy Intervention for Improving Postpartum Sexual Health.}},
author = {Nikolina Zaplatić Degač and Ivana Živoder and Špela Bogataj},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/healthcare14193277},
url = {https://europepmc.org/article/MED/42881716},
note = {CC BY},
}
RIS
TY - JOUR
TI - The POSH-Ex Study: Study Protocol for a Randomized Controlled Trial of a 12-Week Online Physiotherapy Intervention for Improving Postpartum Sexual Health.
AU - Nikolina Zaplatić Degač
AU - Ivana Živoder
AU - Špela Bogataj
PY - 2026
DA - 2026/10/02
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193277
UR - https://europepmc.org/article/MED/42881716
AB - Background/objectives Postpartum sexual dysfunction is common and multifactorial, yet structured physiotherapy interventions specifically targeting sexual function after childbirth remain insufficiently investigated. This study aims to evaluate the effectiveness of Postpartum Sexual Health Exercise (POSH-Ex), a standardized, multimodal, physiotherapist-led online therapeutic exercise programme designed to improve postpartum sexual function. We hypothesise that participants allocated to POSH-Ex will have a higher mean FSFI total score at 12 weeks than participants receiving usual postpartum care, after adjustment for baseline FSFI score.Methods This randomized controlled trial will include 84 women recruited at 10-12 weeks postpartum and randomly allocated (1:1) to the POSH-Ex intervention or control group. The intervention will consist of a 12-week progressive programme delivered twice weekly in 60-min sessions, integrating pelvic floor muscle training, breathing and relaxation exercises, trunk stabilization, functional strengthening, flexibility, and movement re-education, while the control group will receive usual postpartum care and continue their usual activities without a study-specific exercise intervention. Outcomes will be assessed at baseline and after 12 weeks. Sexual function, assessed using the Female Sexual Function Index (FSFI), is the primary outcome; physical activity (IPAQ-SF), fatigue (FAS), and depressive symptoms (EPDS) are secondary outcomes. The primary analysis will compare FSFI scores at 12 weeks between groups using analysis of covariance (ANCOVA) adjusted for baseline FSFI. The trial was prospectively registered at ClinicalTrials.gov (NCT07747285).Conclusions The POSH-Ex trial is designed to determine whether a structured, multimodal, physiotherapist-led online therapeutic exercise programme improves postpartum sexual function compared with usual postpartum care. If effective, POSH-Ex may inform the development of structured physiotherapy approaches that recognise sexual health as an integral component of comprehensive postpartum care.
SN - 2227-9032
ER -