Adapted Physical Activity Based On Trunk Stabilization And Pelvic Floor Education For Female Pelvic Floor Disorders

This study will include women who reported having a pelvic floor disorder. The study willbe a randomized controlled trial with three measurement time points, before and after theintervention (immediate post‐test and delayed post‐test at 3 months), and two groups. Onegroup will receive Adapted Physical Activity (APA) + education intervention, and thecontrol group will be placed on a waiting list for 3 months. Participants in the controlgroup may then follow the program if they wish.We hypothesize that APA program based on trunk stabilization combined with an educationalintervention improves self‐reported symptoms of pelvic floor disorders, knowledge, andcare‐seeking behavior (including physical activity) compared to a group that receives nointervention. We expect these effects to appear immediately after the intervention(immediate post‐test) and to persist over time (delayed post‐test at 3 months).APA refers both to tailored exercise or sports interventions designed to promote healthamong people with chronic diseases, health conditions, or disabilities and to ascientific discipline that designs and studies interventions for health and educationalpurposes. APA provides a framework for implementing the principles of trunk stabilizationin the context of pelvic floor disorders, notably through learning diaphragmaticbreathing and the co‐activation of the pelvic floor and the transversus abdominis,specific training to strengthen the core muscles, and incorporating dynamic exerciseswith light to moderate impact (jumps, side steps, etc.).Adapted physical activity sessions based on the trunk stabilization principle will last60 minutes and will include 15‐minute warm‐up (body and joint mobilizations from head totoe, and breathing exercise) followed by 30‐minute main continuous session (trunkstabilization and strengthening exercises), and 15‐minute cooldown for stretching andmobility exercises. The programme will be organized in three phases, to be implementedprogressively: (1) learning the diaphragmatic breathing pattern, the co‐activation of thepelvic floor and the transversus abdominis muscles in standing, sitting, and lyingpositions; (2) specifically working the engagement of the transversus abdominis musclesin static, dynamic, and balance exercises while strengthening the core muscles; (3)integrating dynamic exercises with light to moderate impact (jumping, side steps, etc.).Exercise instructions will include posture, pelvic floor engagement, and respiratoryinstructions on effort.The educational sessions will last between 60 to 90 minutes. The first session will focuson the prevalence and common beliefs surrounding the pelvic floor, providing a briefintroduction to common risk factors. The functioning (anatomy, function, andbiomechanics) of the pelvic floor will then be presented using educational anatomicalvideos. In the second session, lifestyle‐related risk factors and preventive measureswill be discussed through a group workshop (e.g. urinary and defecatory physiologies, theimpact of sport, posture, overweight and obesity, and hygiene and dietary recommendationsfor constipation). Participants will be invited to consider how to plan their physicalactivity in anticipation of the end of the program and any obstacles they may need toovercome. The final session will cover the care pathways available for pelvic floordisorders; participants will then be invited to consider how to plan for a potentialfuture appointment with a healthcare professional and any barriers they may need toovercome.