COMPARATIVE EFFICACY OF SUPERVISED AND UNSUPERVISED PELVIC FLOOR MUSCLE TRAINING IN ADOLESCENT FEMALE ATHLETES: A RANDOMIZED CONTROLLED TRIAL

Abstract

Urinary incontinence (UI), particularly stress urinary incontinence (SUI), is a prevalent yet often underreported condition in adolescent female athletes, especially those engaged in high-impact sports. Pelvic floor muscle training (PFMT) has been shown to be an effective non-invasive intervention for UI in adults, but its efficacy in adolescent athletes remains underexplored. This study aimed to compare the effectiveness of supervised versus unsupervised PFMT in reducing UI symptoms among adolescent female athletes. A total of 80 participants aged 13–18 years, with self-reported UI symptoms, were randomly assigned to either the supervised PFMT group (n = 40) or the unsupervised PFMT group (n = 40). The supervised group attended weekly 30-minute sessions with a physiotherapist for 12 weeks, while the unsupervised group received a one-time educational session and followed a home-based protocol. The primary outcome was UI symptom severity, measured by the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI-SF), assessed at baseline and after 12 weeks. Secondary outcomes included self-reported changes in pelvic floor strength, adherence, and correctness of PFMT technique. After 12 weeks, the supervised PFMT group showed a significantly greater reduction in ICIQ-UI-SF scores compared to the unsupervised group (adjusted mean difference = –1.52, p = 0.004). Both groups reported similar levels of adherence, and the supervised group demonstrated more accurate pelvic floor contractions. These findings suggest that supervised PFMT is more effective in reducing UI symptoms in adolescent female athletes than unsupervised PFMT. However, the potential for unsupervised PFMT in larger-scale, low-resource settings warrants further investigation.