Pelvic Floor Muscle Training and Neuromuscular Performance in Women's Rugby

Urinary incontinence is common in women athletes and may affect training participation,confidence, concentration, and sporting performance. Rugby exposes athletes to repeatedimpacts, rapid decelerations, collisions, and high trunk and intra‐abdominal pressuredemands. Conventional pelvic floor muscle training may not fully reflect thesesport‐specific demands.This study is a two‐arm, parallel‐group randomized controlled trial. Eligibleparticipants will be randomized in a 1:1 ratio using a computer‐generated sequenceprepared by an independent researcher. Allocation will be concealed using sealed, opaqueenvelopes.Participants allocated to the intervention will complete a rugby‐tailored pelvic floormuscle training programme delivered remotely by certified pelvic health physiotherapistsand sport scientists. The programme includes education, breathing and posturecoordination, pelvic floor contractions in different positions, pre‐activation beforehigh‐impact tasks ("the Knack"), progressive functional strength and landing tasks,technique correction, and individualized progression. Participants will continue theirusual rugby training. Control participants will continue usual rugby training and willnot complete the study exercise programme during the intervention period. Afterpost‐intervention assessment, control participants will be offered the programmematerials and a remote advisory session.Assessments will combine self‐reported pelvic floor outcomes with force‐plate measures.The ICIQ‐UI SF and Pelvic Floor Dysfunction Screening Tool (PFD‐SENTINEL) will becompleted at baseline and post‐intervention. Neuromuscular testing will includecountermovement jumps, an isometric strength test, and a reactive jump assessment.Adherence will be monitored using participant records, physiotherapist logs, andremote‐session attendance. The principal analysis will compare changes over time betweengroups using a mixed‐effects model or equivalent repeated‐measures approach, withsensitivity analyses adjusted for baseline outcome values and relevant participant andtraining characteristics.