Urinary Incontinence (UI)NCT07757633
Pelvic Floor Muscle Training and Neuromuscular Performance in Women's Rugby
A study testing Rugby-Tailored Pelvic Floor Muscle Training Programme in people with Urinary Incontinence (UI) and Pelvic Floor Disorders, run by Universidad de Granada at 1 site in Spain.
Trial summary
This randomized controlled trial will evaluate whether a rugby-tailored pelvic floor muscle training programme reduces urinary incontinence symptoms and influences neuromuscular performance in professional and semi-professional women rugby players. Read more about this study
- Who is it for?
- Ages 18 to 45 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Urinary Incontinence (UI), Pelvic Floor Disorders
- What is being tested?
- Rugby-Tailored Pelvic Floor Muscle Training Programme
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 48 participants
- Where
- 1 siteSpain
- Study dates
- Sep 2026to Dec 2026
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- Women only
- Healthy volunteers accepted
- Adult
Who may be able to join
- Female rugby player aged 18 to 45 years.
- Competing at professional or semi-professional level.
- Currently participating in an active rugby training and competition schedule.
- Self-reported urinary leakage during the previous four weeks, an ICIQ-UI SF total score ≥3, and reported leakage during physical activity/exercise, coughing or sneezing on the self-diagnostic item.
- Able to understand the study procedures and provide written informed consent.
Who cannot join
- Pregnant at the time of enrolment.
- Childbirth within the previous 12 months.
- Previous pelvic surgery.
- Significant musculoskeletal injury during the previous 6 months, defined as any injury that prevented full participation in rugby training or competition for ≥7 consecutive days, or that could compromise the safe completion of study assessments.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Spain1 site, 1 recruiting
- Recruiting
Faculty of Sport Sciences, University of Granada
Granada, 18071
Javier Courel-Ibáñez, PhD, +34952 69 87 00
About this study
This randomized controlled trial will evaluate whether a rugby-tailored pelvic floor muscle training programme reduces urinary incontinence symptoms and influences neuromuscular performance in professional and semi-professional women rugby players. A total of 48 players aged 18 to 45 years with self-reported urinary incontinence will be randomly assigned in a 1:1 ratio to the pelvic floor muscle training group or a control group.
The intervention group will complete an individualized, remotely supervised programme integrating pelvic floor muscle contractions, breathing and postural coordination, the "Knack" technique, progressive functional exercises, and rugby-relevant movement tasks. The control group will continue usual rugby training without study pelvic floor muscle training during the intervention period.
Outcomes will be measured at baseline and immediately after the intervention. The primary outcome is change in urinary incontinence severity measured with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Secondary outcomes include broader pelvic floor symptom screening, jump performance, maximal isometric lower-limb force, reactive strength, and programme adherence.
Read the detailed description
Urinary incontinence is common in women athletes and may affect training participation, confidence, concentration, and sporting performance. Rugby exposes athletes to repeated impacts, rapid decelerations, collisions, and high trunk and intra-abdominal pressure demands. Conventional pelvic floor muscle training may not fully reflect these sport-specific demands.
This study is a two-arm, parallel-group randomized controlled trial. Eligible participants will be randomized in a 1:1 ratio using a computer-generated sequence prepared by an independent researcher. Allocation will be concealed using sealed, opaque envelopes.
Participants allocated to the intervention will complete a rugby-tailored pelvic floor muscle training programme delivered remotely by certified pelvic health physiotherapists and sport scientists. The programme includes education, breathing and posture coordination, pelvic floor contractions in different positions, pre-activation before high-impact tasks ("the Knack"), progressive functional strength and landing tasks, technique correction, and individualized progression. Participants will continue their usual rugby training. Control participants will continue usual rugby training and will not complete the study exercise programme during the intervention period. After post-intervention assessment, control participants will be offered the programme materials and a remote advisory session.
Assessments will combine self-reported pelvic floor outcomes with force-plate measures. The ICIQ-UI SF and Pelvic Floor Dysfunction Screening Tool (PFD-SENTINEL) will be completed at baseline and post-intervention. Neuromuscular testing will include countermovement jumps, an isometric strength test, and a reactive jump assessment. Adherence will be monitored using participant records, physiotherapist logs, and remote-session attendance. The principal analysis will compare changes over time between groups using a mixed-effects model or equivalent repeated-measures approach, with sensitivity analyses adjusted for baseline outcome values and relevant participant and training characteristics.
- Conditions
- Urinary Incontinence (UI), Pelvic Floor Disorders
- Being tested
- Rugby-Tailored Pelvic Floor Muscle Training Programme
- Keywords
- Women athletes, female athletes, rugby, pelvic floor muscle training, urinary incontinence, stress urinary incontinence, pelvic health, force plates, neuromuscular performance, remote
- Medical subject headings
- Urinary Incontinence, Pelvic Floor Disorders, Urinary Incontinence, Stress
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Rugby-Tailored Pelvic Floor Muscle Training ProgrammeBehavioural
The intervention is an individualized, remotely delivered pelvic floor training programme designed for women rugby players. It combines: (1) pelvic floor muscle awareness, activation, and complete relaxation; (2) coordination with the transversus abdominis, breathing, and posture; (3) progressive pelvic floor contractions in lying, quadruped, standing, and dynamic positions; (4) the "Knack," involving pelvic floor pre-activation before impact or high-pressure tasks; (5) progressive rugby-relevant functional tasks such as squatting, jumping, landing, and repeated impact preparation; and (6) individualized feedback from certified pelvic health physiotherapists.
Dose: 8 weeks, with 3 sessions per week. Adherence is monitored using participant self-reports, physiotherapist records, and remote-session attendance.
| Study group | Role | What they receive |
|---|---|---|
| Rugby-Tailored Pelvic Floor Muscle Training Programme | Experimental | Participants will continue usual rugby training and complete the remotely supervised rugby-tailored pelvic floor muscle training programme. The intervention includes pelvic floor and deep abdominal muscle coordination, breathing and posture exercises, progressive contractions in different positions, the "Knack" before impact-related tasks, functional strength and landing exercises, individualized progression, and remote technique feedback. Receives: Behavioral: Rugby-Tailored Pelvic Floor Muscle Training Programme |
| Control | No intervention | Participants will continue their usual rugby training and will not complete the study pelvic floor muscle exercise programme during the intervention period. After post-intervention assessment, they will be offered access to the programme materials and one remote advisory session with a pelvic health physiotherapist. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) total score
Urinary incontinence symptom severity will be assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF). The questionnaire contains three scored items assessing urinary-leakage frequency, amount of leakage and interference with everyday life. The total score ranges from 0 to 21 points, with higher scores indicating greater urinary incontinence severity and impact and therefore a worse outcome. Change will be calculated as the score at 8 weeks minus the baseline score; a negative change indicates improvement. The primary endpoint will be the between-group difference in change from baseline to 8 weeks.
Measured: Baseline and immediately after the intervention (8 weeks)
Secondary outcomes (9)
Change in Pelvic Floor Dysfunction Screening Tool in Female Athletes (PFD-SENTINEL) symptom count
Pelvic floor dysfunction symptoms will be assessed using the Pelvic Floor Dysfunction Screening Tool in Female Athletes, known as PFD-SENTINEL. The instrument includes five binary pelvic floor symptom indicators. A study-defined symptom count will be calculated by summing the number of symptoms reported, producing a score from 0 to 5. Higher scores indicate a greater number of pelvic floor dysfunction symptom categories and therefore a worse outcome. A count of at least one symptom meets the PFD-SENTINEL criterion for direct referral to a pelvic floor specialist. Change will be calculated as the score at 8 weeks minus the baseline score; a negative change indicates improvement.
Measured: Baseline and immediately after the intervention (8 weeks)
Change in Pelvic Floor Dysfunction Screening Tool in Female Athletes (PFD-SENTINEL) risk, clinical and sport-related item count
Risk factors and clinical and sport-related characteristics will be assessed using the Pelvic Floor Dysfunction Screening Tool in Female Athletes, known as PFD-SENTINEL. The instrument contains 28 binary risk, clinical and sport-related items. A study-defined item count will be calculated by summing the number of items reported, producing a score from 0 to 28. Higher scores indicate a greater number of characteristics associated with potential pelvic floor dysfunction and therefore a worse outcome. A count of 14 or more items meets the PFD-SENTINEL criterion for direct referral to a pelvic floor specialist. Change will be calculated as the score at 8 weeks minus the baseline score; a negative change indicates improvement.
Measured: Baseline and immediately after the intervention (8 weeks)
Change in countermovement jump height
Countermovement jump height will be assessed using a force plate. Participants will perform three maximal countermovement jumps with their hands maintained on their hips. Jump height will be recorded in centimetres. Higher values indicate greater vertical jump performance and therefore a better outcome. The highest value obtained from the three valid trials will be used for analysis.
Measured: Baseline and immediately after the intervention (8 weeks)
Change in maximal isometric squat peak force
Lower-body maximal isometric strength will be assessed using a force plate during three maximal isometric squat trials performed at a knee angle of approximately 110 degrees. Peak force will be recorded in newtons. Higher values indicate greater maximal isometric strength and therefore a better outcome. The highest peak-force value obtained from the three valid trials will be used for analysis.
Measured: Baseline and immediately after the intervention (8 weeks)
Change in Reactive Strength Index during the countermovement rebound jump
Reactive jump performance will be assessed using a force plate during three maximal countermovement rebound jump trials performed with the hands maintained on the hips. Reactive Strength Index will be calculated as rebound jump height in metres divided by ground contact time in seconds and will be expressed in metres per second. Higher values indicate greater reactive jump performance and therefore a better outcome. The highest Reactive Strength Index obtained from the three valid trials will be used for analysis.
Measured: Baseline and immediately after the intervention (8 weeks)
Change in self-reported amount of urinary leakage during the countermovement jump test
Immediately after completing the three countermovement jump trials, participants will report the amount of urinary leakage experienced during the test using the response categories from the amount-of-leakage item of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. The item is scored as 0 = no leakage, 2 = a small amount, 4 = a moderate amount, and 6 = a large amount. Possible scores range from 0 to 6, with higher scores indicating a greater amount of urinary leakage and therefore a worse outcome. Change will be calculated as the score at 8 weeks minus the baseline score; a negative change indicates improvement.
Measured: Baseline and immediately after the intervention (8 weeks)
Change in self-reported amount of urinary leakage during the isometric squat test
Immediately after completing the three maximal isometric squat trials performed at a knee angle of approximately 110 degrees, participants will report the amount of urinary leakage experienced during the test using the response categories from the amount-of-leakage item of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. The item is scored as 0 = no leakage, 2 = a small amount, 4 = a moderate amount, and 6 = a large amount. Possible scores range from 0 to 6, with higher scores indicating a greater amount of urinary leakage and therefore a worse outcome. Change will be calculated as the score at 8 weeks minus the baseline score; a negative change indicates improvement.
Measured: Baseline and immediately after the intervention (8 weeks)
Change in self-reported amount of urinary leakage during the countermovement rebound jump test
Immediately after completing the three countermovement rebound jump trials, participants will report the amount of urinary leakage experienced during the test using the response categories from the amount-of-leakage item of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. The item is scored as 0 = no leakage, 2 = a small amount, 4 = a moderate amount, and 6 = a large amount. Possible scores range from 0 to 6, with higher scores indicating a greater amount of urinary leakage and therefore a worse outcome. Change will be calculated as the score at 8 weeks minus the baseline score; a negative change indicates improvement.
Measured: Baseline and immediately after the intervention (8 weeks)
Adherence to the pelvic floor muscle training programme
Throughout the intervention period (weeks 1-8)
Measured: Adherence will be summarized as the percentage of prescribed home-training sessions completed, based on weekly participant self-reports.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Aug 2026
- Study startSep 2026 (estimated)
- Primary completionDec 2026 (estimated)
- Study completionDec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Urinary Incontinence (UI)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Two parallel groups: rugby-tailored pelvic floor muscle training plus usual rugby training versus usual rugby training without study pelvic floor muscle training.
- Masking
- Triple blind
- Who is masked
- Care provider, Investigator, Outcomes assessor
- Enrolment
- 48 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Universidad de Granada
- Sponsor type
- University, hospital or other
- Collaborators
- World Rugby Research Unit
- Responsible party
- Principal investigator, Javier Courel Ibáñez, Universidad de Granada
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07757633
- Sponsor's protocol ID
- G-2504-06806
- Status last verified
- Aug 2026
- First submitted
- 2 Aug 2026
- Last updated
- 11 Aug 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: There is no current plan to share de-identified individual participant data with researchers outside the primary study team. The study protocol and participant consent procedures did not prospectively establish a mechanism for external IPD sharing. Study findings will be disseminated through aggregate analyses in peer-reviewed publications, research reports, and scientific presentations.
Publications
Dakic J, Perraton L, Lindstrom J, Hain E, Chuah S, Stay S. The Hidden Challenge: Pelvic Floor Symptoms and Their Impact on Performance and Well-Being in Elite Female Rugby Players. Eur J Sport Sci. 2025 Aug;25(8):e70013. doi: 10.1002/ejsc.70013.
PubMed 40650437Donnelly GM, Bo K, Forner LB, Rankin A, Moore IS. Up for the tackle? The pelvic floor and rugby. A review. Eur J Sport Sci. 2024 Dec;24(12):1719-1734. doi: 10.1002/ejsc.12121. Epub 2024 May 11.
PubMed 39639650Dominguez-Perez N, Sevilla-Arrabal I, Navarro-Brazalez B, Torres-Lacomba M, Courel-Ibanez J. Urinary Incontinence in Women Athletes: Umbrella Review and Meta-analysis of Sport-Related Factors. Sports Med. 2026 Apr 16. doi: 10.1007/s40279-026-02438-z. Online ahead of print.
PubMed 41989514