Comparative Effects of Hypopressive Exercises and Paula Method in Postpartum Women.

Stress urinary incontinence (SUI) is a prevalent pelvic floor disorder among postpartumwomen specially with multi‐parity, significantly affecting their physical, psychological,and social well‐being. Repeated vaginal deliveries can lead to pelvic floor muscleweakness, reduced support to pelvic organs, and impaired urinary control. Manynon‐invasive physical therapy strategies have gained popularity, particularly among womenunable to effectively contract their pelvic floor muscles voluntarily. Two suchtechniques are Hypopressive Exercises and the Paula Method. Hypopressive exercisesinvolve specific breathing patterns combined with postural adjustments that activate thepelvic floor through reflex mechanisms. In contrast, the Paula Method is based on theconcept of muscular synergy among circular muscles. It utilizes rhythmic contractions ofperipheral circular muscles (such as the eyes, lips, and sphincters) to stimulate thepelvic floor, making it especially beneficial for individuals with coordination issues ordiscomfort performing direct pelvic contractions.This study will be a randomized clinical trial with a sample size of 60 postpartumfemales. The setting of the study will be Bilal Medicare, Sargodha. 60 postpartum womenwill be included based on age, parity, mode of delivery and type of urinary incontinence.Women with primary gravida, cesarean section and urge and mixed urinary incontinence willbe excluded. This study aims to compare the effectiveness of Hypopressive Exercises andthe Paula Method in improving urinary incontinence severity, pelvic floor muscle strengthand quality of life in postpartum women. Patients of both groups receive two treatmentsessions per week over an 8‐week period. Group A will be given Hypopressive exercise andGroup B will be given Paula exercise protocol. Both groups will perform a standardizedkegel exercises for pelvic floor muscle activation and strengthening as baselinetreatment followed by their assigned interventions. Outcome measures will include theInternational Consultation on Incontinence Questionnaire (ICIQ‐UI SF), Modified OxfordScale for muscle strength, and Incontinence Impact Questionnaire (IIQ‐7) for QoLassessment. Data will be statistically analyzed using SPSS version 25.