Comparative Effects of Kegel Exercises and Squat on Urinary Incontinence Severity and Quality of Life

Abstract

Background: Urinary incontinence (UI) is a common condition among women, associated with impaired quality of life, social stigma, and increased healthcare burden. Conservative management strategies such as pelvic floor muscle training are widely recommended as first-line interventions. While Kegel exercises are the most established approach, squat-based training has been proposed as an alternative for enhancing pelvic and core muscle strength. Evidence comparing the two interventions remains limited, particularly in South Asian populations. Objective: To compare the effects of Kegel exercises and squat training on urinary incontinence severity and health-related quality of life among women with UI. Methods: A randomized clinical trial was conducted at two teaching hospitals in Faisalabad, enrolling 26 women aged 30–60 years with clinically confirmed UI. Participants were randomly allocated into two groups: Kegel exercise group (n=14) and squat exercise group (n=12). Both groups received baseline transcutaneous electrical nerve stimulation followed by 12 weeks of daily exercises. Outcomes were assessed using the Incontinence Quality of Life questionnaire (I-QOL) and the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms Long Form (ICIQ-FLUTS-LF). Data were analyzed with paired and independent t-tests, effect sizes, and confidence intervals. Results: Both groups demonstrated significant improvements (p<0.001). The Kegel group achieved greater gains in I-QOL (+57.7 vs +37.0) and larger reductions in ICIQ scores (–0.34 vs –0.12) compared to squats, with between-group differences favoring Kegels (p=0.004). Conclusion: Kegel exercises were more effective than squats in improving quality of life and reducing symptom severity in women with UI, supporting their role as the preferred conservative treatment