Pelvic floor muscle training combined with general exercises in hydrotherapy or on land for women with gestational diabetes mellitus: a randomized clinical trial protocol

Abstract

Introduction: Urinary incontinence is common during pregnancy, and gestational diabetes mellitus (GDM) may affect pelvic floor muscle (PFM) function. Evidence on specific pelvic floor muscle training (PFMT) protocols for women with GDM remains limited. Objective: To describe the protocol of a randomized controlled trial evaluating PFMT combined with global exercises in hydrotherapy or on land on PFM function and pregnancy-specific urinary incontinence (PSUI) in women with GDM. Methods: Pregnant women aged 18–35 years, at 24–28 weeks of gestation, with or without GDM, will undergo 8 weeks of supervised exercise, twice weekly. PFM function will be assessed by digital palpation, surface electromyography, 3D/4D ultrasonography, and elastography. PSUI, quality of life, and trunk muscle function will also be assessed by a blinded evaluator. Expected Results: Improvements in PFM function, PSUI, and quality of life are expected, with possible differences between aquatic and land-based training. Conclusion: This protocol may contribute to evidence-based strategies for managing PFM dysfunction and PSUI during pregnancy.