The effect of pelvic floor muscle exercise, progressive muscle relaxation exercise, and their combined application on comfort in women with stress urinary incontinence: a four-arm randomized controlled trial
- 1Department of Urology, Faculty of Medicine, Karamanoğlu Mehmetbey University , ,
- 2Department of Nursing, Faculty of Health Sciences, Karamanoğlu Mehmetbey University , ,
- 3Department of Physical Therapy and Rehabilitation, Karaman Training and Research Hospital , ,
Abstract
Background: Stress urinary incontinence (SUI) negatively affects women's physical, psychological, and social well-being and reduces comfort. Although pelvic floor muscle exercise (PFME) is the first-line conservative treatment, the additional contribution of progressive muscle relaxation exercise (PMR) to patient comfort remains unclear. This study aimed to evaluate the effects of PFME, PMR, and their combined application on comfort levels in women with SUI.
Methods: This four-arm randomized controlled trial included 80 women diagnosed with SUI who were randomly assigned to the PFME group (n = 20), PMR group (n = 20), PFME + PMR group (n = 20), or control group (n = 20). Data were collected using a Descriptive Information Form and the Urinary Incontinence Frequency and Comfort Questionnaire (UIFCQ). Participants in the intervention groups performed the assigned exercise program for six weeks. Comfort was assessed at baseline and at Weeks 2, 4, and 6 through telephone interviews. Data were analyzed using descriptive statistics and mixed-design analysis of variance (Mixed ANOVA). A p-value of <0.05 was considered statistically significant.
Results: Baseline comfort scores did not differ significantly among the groups (p > 0.05). Significant effects of time and the group×time interaction were observed (p < 0.001). Participants in the PFME group demonstrated significant improvements in comfort beginning at Week 2, which were maintained throughout the study. The PMR group showed gradual improvements in comfort across the follow-up period. In the combined PFME + PMR group, significant improvements became evident at the third and fourth assessments. Although slight changes were observed in the control group over time, the trajectories of improvement in all intervention groups were significantly greater than those in the control group.
Conclusions: PFME, PMR, and their combined application improved comfort over time in women with stress urinary incontinence. These findings suggest that structured conservative interventions, particularly the integration of PMR into pelvic floor rehabilitation programs, may enhance patient comfort and support comprehensive SUI management. Further multicenter randomized controlled trials with larger sample sizes and longer follow-up periods are warranted.
Clinical trial registration: ClinicalTrials.gov, Identifier: NCT07762391, https://clinicaltrials.gov/study/NCT07762391
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BibTeX
@article{sanlı2026effect,
title = {{The effect of pelvic floor muscle exercise, progressive muscle relaxation exercise, and their combined application on comfort in women with stress urinary incontinence: a four-arm randomized controlled trial}},
author = {Ahmet Şanlı and Gamze Göke Arslan and Demet Çelik and Burak Demir},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1967374},
url = {https://europepmc.org/article/PMC/PMC13727397},
note = {CC BY},
}
RIS
TY - JOUR
TI - The effect of pelvic floor muscle exercise, progressive muscle relaxation exercise, and their combined application on comfort in women with stress urinary incontinence: a four-arm randomized controlled trial
AU - Ahmet Şanlı
AU - Gamze Göke Arslan
AU - Demet Çelik
AU - Burak Demir
PY - 2026
DA - 2026/10/20
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1967374
UR - https://europepmc.org/article/PMC/PMC13727397
AB - Background: Stress urinary incontinence (SUI) negatively affects women's physical, psychological, and social well-being and reduces comfort. Although pelvic floor muscle exercise (PFME) is the first-line conservative treatment, the additional contribution of progressive muscle relaxation exercise (PMR) to patient comfort remains unclear. This study aimed to evaluate the effects of PFME, PMR, and their combined application on comfort levels in women with SUI. Methods: This four-arm randomized controlled trial included 80 women diagnosed with SUI who were randomly assigned to the PFME group (n = 20), PMR group (n = 20), PFME + PMR group (n = 20), or control group (n = 20). Data were collected using a Descriptive Information Form and the Urinary Incontinence Frequency and Comfort Questionnaire (UIFCQ). Participants in the intervention groups performed the assigned exercise program for six weeks. Comfort was assessed at baseline and at Weeks 2, 4, and 6 through telephone interviews. Data were analyzed using descriptive statistics and mixed-design analysis of variance (Mixed ANOVA). A p-value of <0.05 was considered statistically significant. Results: Baseline comfort scores did not differ significantly among the groups (p > 0.05). Significant effects of time and the group×time interaction were observed (p < 0.001). Participants in the PFME group demonstrated significant improvements in comfort beginning at Week 2, which were maintained throughout the study. The PMR group showed gradual improvements in comfort across the follow-up period. In the combined PFME + PMR group, significant improvements became evident at the third and fourth assessments. Although slight changes were observed in the control group over time, the trajectories of improvement in all intervention groups were significantly greater than those in the control group. Conclusions: PFME, PMR, and their combined application improved comfort over time in women with stress urinary incontinence. These findings suggest that structured conservative interventions, particularly the integration of PMR into pelvic floor rehabilitation programs, may enhance patient comfort and support comprehensive SUI management. Further multicenter randomized controlled trials with larger sample sizes and longer follow-up periods are warranted. Clinical trial registration: ClinicalTrials.gov, Identifier: NCT07762391, https://clinicaltrials.gov/study/NCT07762391
SN - 2296-858X
ER -