Effect of Knack Pelvic Floor Contraction on Sexual Dysfunction

NCT ID: NCT07145216

Last Updated: 2025-08-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-01

Study Completion Date

2026-01-30

Brief Summary

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This study aims to investigate the effect of knack pelvic floor contraction on sexual dysfunction in females with stress urinary incontinence.

Detailed Description

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Stress urinary incontinence may have a tremendous effect on psychological and social well-being. Women with SUI report an inferior health-related quality of life (HRQOL) compared to continent women. Sexual well-being is an important aspect of women's health, and dysfunction can lead to a decrease in HRQOL and affect the marital relationship. It has been reported that women with UI also have problems with sexual activity. The presence of urinary leakage during intercourse can adversely affect sexual function.

Physiotherapy treatments for female SUI include PFMT such as knack maneuver, biofeedback, electrical stimulation, core stabilization, diet modifications, and behavioral therapy.

The knack is a simple, quick exercise technique that improves bladder control and increases PFM strength; it increases the urethral closure pressure, improves bladder stabilization and increases the structural support during PFM contraction. A previous study compared the knack effect on SUI using different methods like EMG biofeedback, verbal instructions, and vaginal palpation. It was found to have a positive impact on urinary symptoms, regardless of the teaching methods. Another previous study investigated the knack effect on vaginal laxity and found that it improved PFM contraction and sexual function and reduced vaginal laxity.

Up to now, no study has investigated the effect of the knack maneuver on female SUI associated with sexual problems, so this study will be the first one on this issue; therefore this study will be of valuable benefits and increase the knowledge of the physical therapist and health care provider in the women's health field.

Conditions

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Stress Urinary Incontinence (SUI) Sexual Dysfunction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Interferential stimulation

It will include 20 participants suffering from SUI associated with sexual dysfunction who will receive interferential stimulation for 20 minutes, 3 days per week for 8 weeks.

Group Type ACTIVE_COMPARATOR

Interfrential stimulation

Intervention Type OTHER

The participant will be positioned in semi-Fowler's position. Interferential therapy was given using the quadripolar method. Two electrodes were placed on the lower abdomen just above the outer half of the inguinal ligament, and another two on the inner aspect of the thigh near the origin of the adductor muscle. At the first treatment session, every participant will be examined for pelvic floor contraction by the finger palpation method using sterilized gloves to ensure the correct position of the electrodes. It will be set with intensity up to the tolerable limit of subjects, carrier frequency of 2000Hz, vector 900, rhythmic sweep frequency of 10-100Hz, and duration 20 minutes. Interferential therapy will be applied for the treatment procedure of all women in both groups for 20 minutes, 3days per week for 8 weeks.

Interferential stimulation + Knack pelvic floor exercise

It will include 20 participants suffering from SUI with sexual dysfunction who will receive interferential stimulation for 20 minutes in addition to the knack maneuver for 15 minutes, 3 days per week for 8 weeks.

Group Type EXPERIMENTAL

Interfrential stimulation

Intervention Type OTHER

The participant will be positioned in semi-Fowler's position. Interferential therapy was given using the quadripolar method. Two electrodes were placed on the lower abdomen just above the outer half of the inguinal ligament, and another two on the inner aspect of the thigh near the origin of the adductor muscle. At the first treatment session, every participant will be examined for pelvic floor contraction by the finger palpation method using sterilized gloves to ensure the correct position of the electrodes. It will be set with intensity up to the tolerable limit of subjects, carrier frequency of 2000Hz, vector 900, rhythmic sweep frequency of 10-100Hz, and duration 20 minutes. Interferential therapy will be applied for the treatment procedure of all women in both groups for 20 minutes, 3days per week for 8 weeks.

Knack pelvic floor training

Intervention Type OTHER

The knack technique (Fitz et al., 2021):

* The patient will be instructed to lie in supine lying position with flexed knees.
* Ask the patient to contract the pelvic floor muscles for 2-4 seconds and relax for 4 seconds for 15 repetitions with 3 sets before and during coughing or sneezing .
* Contract the PFM before and during all daily activities involving effort, before and during coughing, sneezing, laughing, walking up and down stairs, jumping, running, bending, lifting a weight from the floor, holding a child, pushing furniture to prevent urine leakage.
* Contract PFM and hold for 2-4 seconds, relax 4 seconds, with 3 sets of 15 repetitions.

Interventions

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Interfrential stimulation

The participant will be positioned in semi-Fowler's position. Interferential therapy was given using the quadripolar method. Two electrodes were placed on the lower abdomen just above the outer half of the inguinal ligament, and another two on the inner aspect of the thigh near the origin of the adductor muscle. At the first treatment session, every participant will be examined for pelvic floor contraction by the finger palpation method using sterilized gloves to ensure the correct position of the electrodes. It will be set with intensity up to the tolerable limit of subjects, carrier frequency of 2000Hz, vector 900, rhythmic sweep frequency of 10-100Hz, and duration 20 minutes. Interferential therapy will be applied for the treatment procedure of all women in both groups for 20 minutes, 3days per week for 8 weeks.

Intervention Type OTHER

Knack pelvic floor training

The knack technique (Fitz et al., 2021):

* The patient will be instructed to lie in supine lying position with flexed knees.
* Ask the patient to contract the pelvic floor muscles for 2-4 seconds and relax for 4 seconds for 15 repetitions with 3 sets before and during coughing or sneezing .
* Contract the PFM before and during all daily activities involving effort, before and during coughing, sneezing, laughing, walking up and down stairs, jumping, running, bending, lifting a weight from the floor, holding a child, pushing furniture to prevent urine leakage.
* Contract PFM and hold for 2-4 seconds, relax 4 seconds, with 3 sets of 15 repetitions.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Females with mild and moderate degrees of SUI according to Incontinence Severity Index score (mild: 1-2; and moderate: 3-4 scoring).
2. Their ages will range from 25 to 45 years old.
3. Their body mass index (BMI) will be less than 30 kg/m2.
4. They are multiparous women.
5. Females complain of sexual disorders related to SUI, identified by an FSFI score of less than 28.1
6. They have a sedentary lifestyle.

Exclusion Criteria

1. Severe degree of SUI.
2. Other types of urinary incontinence, such as urge urinary incontinence and mixed urinary incontinence.
3. Other neurological diseases such as myasthenia gravis and Parkinsonism.
4. History of pelvic fractures.
5. Menopausal women.
6. Females with pelvic organ prolapse (POP).
Minimum Eligible Age

25 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Cairo University

OTHER

Sponsor Role lead

Responsible Party

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Wafaa Ibrahim Hussein

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Doaa A. Osman, PHD

Role: STUDY_CHAIR

Department of Women's Health, Faculty of Physical Therapy, Cairo University

Locations

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Faculty of Physical Therapy

Giza, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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Wafaa I. Hussein, B.Sc

Role: CONTACT

01005660816

Manal A. El-Shafei, PHD

Role: CONTACT

01220664518

Facility Contacts

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Wafaa I. Hussein, B.Sc

Role: primary

01005660816

Manal A El-Shafei, PHD

Role: backup

Other Identifiers

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P.T.REC/012/005672

Identifier Type: -

Identifier Source: org_study_id

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