Supervised Pelvic Floor Muscle Training vs. Yoga-Based Pelvic Exercises on Stress Urinary Incontinence in Postpartum Women: A Randomized Controlled Trial

Abstract

Background: Stress urinary incontinence (SUI) is a common postpartum complication that adversely affects women’s physical, psychological, and social well-being. Pelvic floor muscle training (PFMT) is considered the gold-standard conservative management, while yoga-based pelvic exercises have emerged as a potential complementary option. However, comparative evidence between the two approaches in postpartum women is limited. Objective: To evaluate and compare the effectiveness of supervised PFMT and yoga-based pelvic exercises in reducing symptom severity, improving pelvic floor muscle strength, and enhancing quality of life in postpartum women with SUI. Methods: A randomized controlled trial was conducted at a physiotherapy clinic in Lahore, Pakistan, enrolling 60 postpartum women diagnosed with SUI. Participants were randomly assigned to supervised PFMT (n=30) or yoga-based pelvic exercises (n=30) for eight weeks. Primary outcome was change in ICIQ-SF score; secondary outcomes included pelvic floor muscle strength and quality of life. Data were analyzed using t-tests, chi-square tests, and ANCOVA, with significance set at p<0.05. Results: Both interventions significantly improved outcomes, but PFMT showed greater reductions in ICIQ-SF scores (mean reduction -7.8 vs. -6.1; p=0.02), higher progression in Oxford strength grades, and greater quality of life improvements (+2.1 vs. +1.6; p=0.02). Conclusion: Supervised PFMT demonstrated superior efficacy compared to yoga-based pelvic exercises, though both interventions were beneficial. PFMT should remain the first-line conservative management, while yoga may be considered a feasible adjunct in resource-limited settings.