Effects of PEMM in Chronic Low Back Pain Women With Urinary Incontinence

NCT07351851 | Recruiting DMC

• 1 other identifier: MRC-01-24-698
• Study Type: interventional
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

Urinary incontinence (UI), Chronic low back pain (CLBP) in women are prevalent and often coexist. Multiple conditions when coexist, it leads to reduced Quality of life in turn causing physical and mental impairment. Musculoskeletal structures and fascial restrictions is one of the attribute to the coexistence of urinary incontinence and chronic back pain in women. External myofascial mobilization (EMM) with core exercises have been proven beneficial for conditions in males that is caused by musculoskeletal and fascial structures. However there are limited research which proves the effect of EMM in conditions involving musculoskeletal and fascial structures . Therefore, the aim of the study is to find the effect of MFTs in reducing the disability in women with CLBP and UI PRIMARY OBJECTIVE To evaluate the effectiveness of PEMM treatment in reducing disability, pain and improving mental health in women with CLBP and UI Study design : Simple randomization Sampling method: Simple Random sampling Random numbers will be generated in Excel, then random numbers will be presented in a concealed envelope for the participants to choose Sample Size : 130 (Experimental 65, Control 65) Sample size was determined using expected effect size i.e., mean change in the primary outcome variable disability index reported in the recent research study . With effect size (change in the disability index score) 3.5 and standard deviation of the change in the outcome 6.45, statistical power 80% and level of significance 5%, the required sample size would be n=55 participants in each group. However, to accounts for multiple secondary outcome measures, possible dropouts and non-response it would be good to increase an additional 20% in calculated sample size i.e., a total of 130 participants (65 participants in each group) will be included in this study. The following sample size equation was used to determine adequate sample size:n = \[2 (Z?/2 + Z?)2 \* ?2\] / (m1-m2)2 Where Z? and Z? are the values standard normal variate e.g., at 5% level of significance Z?/2 = 1.96, and with 80% power the value of Z?= 0.84; ? is the polled Standard deviation and m1 and m2 are the mean outcome values s in group 1 and group 2 respectively. Blinding: Single blinding: patient will be blinded to the group allocation. The assessor is blinded to the treatment Material and tools : Theragun - Theragun Elite, 20 V, Myofascial tools - foam roll, foam ball, Questionnaires - SF 3642,43,44, Oswestry Low back pain questionnaire (ODI)45 and The International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF)46 PROCEDURE In the course of the study the total number of patients referred to physiotherapy department with LBP will be interviewed to identify patients with or without UI having LBP. The data obtained from this will be recoded as prevalence in results. The documents of the patients having LBP with UI will be reviewed to check who fulfills the inclusion criteria. All who meets the inclusion criteria will be approached face to face with the aim of the study. Informed consent form will be given to patients who are volunteering to participate in the study. The data of the participants who do not wish to participate in the study will also be recorded. The participants who have consented to participate in the study will be then assessed. Since the participants has UI she will be directed to a Urologist for an assessment. After urologist assessment, patients will be randomly allocated to experimental and control groups. Random allocation will be administered by the random numbers generated and will be presented in a concealed envelope for the participants to choose. 1st week, the demographic data and Outcome measure of pain, SF36, ODI, ICIQ-UI-SF will be recorded (1st time) on the day of assessment. The outcome measures will be printed on paper and will be given to the patients to fill up with a pen, all questionnaires are self reported outcome measures. Treatment will commence a week after, where experimental group will undergo PEMM therapy with strengthening for 6 weeks duration and the control group will have conventional symptomatic pain treatment with strengthening (2nd to 7th week). Treatment will be given for 6 weeks (1 sessions in a week). The treatment day may vary any day between 4th and 7th day post one session. After 6 sessions of treatment, patient will be advised HEP (Home exercise program) to continue at home. Reassessment will be done on the 8th week where the outcome measures of pain, SF36, ODI, ICIQ-UI-SF will be recorded. Participants will be educated and advised regarding HEP. Exercises will be taught to the patient by explanation, demonstration, teach-back method, and printed sheet of exercise. Compliance to HEP will be recorded before final Outcome measure

Conditions

Chronic Low-back Pain (cLBP); Urinary Incontinence (UI); Pelvic External Myofascial Mobilisation; Myofascial Techniques; Pelvic Pain

Keywords

chronic low back pain; urinary incontinence; myofascial mobilisation; PEMM; female pelvic pain

Outcome Measures

Primary Outcomes (3)

• VAS Pain

  Visual analogue scale

  Week 1 and week 8

• Oswestry disability index

  Week 1 and week 8

• urinary incontinence scale

  ICIQ-UI-SF - International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form

  Week 1 and week 8

Secondary Outcomes (1)

• mental and physical quality of life

  Week 1 and week 8

Study Arms (2)

PEMM

EXPERIMENTAL

PEMM therapy with theragun and strengthening for 6 weeks duration.

Other: PEMM with Theragun

Control

ACTIVE COMPARATOR

TENS and hot pack for 15 min, symptomatic pain treatment with strengthening for 6 weeks duration.

Other: Active Comparator: Control

Interventions

PEMM with Theragun OTHER

PEMM will be given with theragun at specific assessed points and strengthening exercises will be given

Also known as: Pelvic External Myofascial Mobilisation

PEMM

Active Comparator: Control OTHER

Pain modulation will be given with TENS and hot pack, and strengthening exercises will be given

Also known as: TENS and strengthening

Control

Eligibility Criteria

• Age: 18 Years - 65 Years
• Gender Eligibility Details: females only
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age group of 18 - 65 years
• Has child/children \<5 parity
• CLBP patients with UI referred for physiotherapy for CLBP
• Patient with low back pain for more than 3 months
• NRS more than 5/10
• Patient with complain of urinary incontinence since past 3 months or more

You may not qualify if:

• Chronic Low Back Pain with red flags
• Not able to read and write in English /Arabic
• Pregnant ladies and post partum 1 year
• UTI, Pelvic floor Surgery
• Any systemic condition of renal and cardiac
• Patient with active carcinoma or any inflammatory disease

Sponsors & Collaborators

• Hamad Medical Corporation: lead

Study Sites (1)

Hamad Medical Corporation

Doha, Baladīyat ad Dawḩah, 0000, Qatar

RECRUITING

Related Publications (28)

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MeSH Terms

Conditions

Urinary Incontinence; Pelvic Pain

Interventions

Transcutaneous Electric Nerve Stimulation

Condition Hierarchy (Ancestors)

Urination Disorders; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Lower Urinary Tract Symptoms; Urological Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations

Intervention Hierarchy (Ancestors)

Electric Stimulation Therapy; Therapeutics; Physical Therapy Modalities; Rehabilitation; Analgesia; Anesthesia and Analgesia

Central Study Contacts

MANISHA P SHENOY, Masters

CONTACT

+97450202795; mshenoy@hamad.qa

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Reassessment will be done on the 8th week where the outcome measures of pain, SF36, ODI, ICIQ-UI-SF will be recorded. an independent assessor will be assigned for the recording. the assessor will not have access to the inital recording of outcome measure
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinician: Physiotherapy Specialist

Model Details: The study will involve recruiting women having UI and CLBP. Patients meeting the inclusion criteria will be randomly allocated in experimental and control group

Study Record Dates

• First Submitted: December 30, 2025
• First Posted: January 20, 2026
• Study Start: September 29, 2025
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): December 1, 2027
• Last Updated: January 20, 2026

Record last verified: 2025-09

Locations

QA (1)