Effects of Action Observation and Metaphorical Imagery in Pelvic Floor Muscle Training for Geriatric Urinary Incontinence

NCT07551674 | Recruiting

• 1 other identifier: 1002-GERIATRICS-UI
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

This clinical trial investigates the effects of a 12-week Pelvic Floor Muscle Training (PFMT) program applied via Action Observation Therapy (AOT) with metaphorical imagery on urinary incontinence, quality of life, and treatment adherence in geriatric women. The study will be conducted between June 2025 and June 2026 in nursing homes in Istanbul, targeting women aged 65 and older who are diagnosed with stress or stress-predominant mixed urinary incontinence, possess normal cognitive function (Standardized Mini Mental Test score ≥ 24), and walk independently. Eligible participants will be divided into groups, where both will undergo a progressive exercise regimen involving twice-weekly 45-50 minute group sessions that advance from supine positions to standing and jumping movements. However, the AOT study group will uniquely perform these exercises while observing and imagining projected metaphor-themed visuals to enhance motor learning and motivation. Efficacy will be evaluated pre- and post-intervention using various standardized tools, including the Pelvic Floor Distress Inventory-20, a 24-hour pad test, the Incontinence Severity Index, the Movement Imagery Questionnaire-3, and the Incontinence Quality of Life Scale, to comprehensively assess improvements in incontinence severity, functional status, and overall well-being.

Conditions

Urinary Continence

Keywords

urinary incontinence; geriatrics; action observation

Outcome Measures

Primary Outcomes (4)

• Mini-Mental State Examination

  Baseline and after 12-weeks

• Pelvic Floor Distress Inventory

  Baseline and after 12-weeks

• The Incontinence Severity Index

  Baseline and after 12-weeks

• Movement Imagery Questionnaire-3

  Baseline and after 12-weeks

Secondary Outcomes (2)

• Geriatric Self-Efficacy Index for Urinary Incontinence

  Baseline and after 12-weeks

• Incontinence Quality of Life Questionnaire

  Baseline and after 12-weeks

Study Arms (2)

Pelvic Floor Muscle Training program

EXPERIMENTAL

Exercise

Other: Pelvic Floor Muscle Training program

Pelvic Floor Muscle Training via Action Observation Therapy

EXPERIMENTAL

Exercise with AOT

Other: Pelvic Floor Muscle Training via Action Observation Therapy

Interventions

Pelvic Floor Muscle Training program OTHER

Participants will engage in a 12-week Pelvic Floor Muscle Training (PFMT) program. The exercises will be conducted twice a week in group sessions lasting 45-50 minutes each. These sessions will be supervised by a physiotherapist and performed in small groups of five participants.

Pelvic Floor Muscle Training program

Pelvic Floor Muscle Training via Action Observation Therapy OTHER

Participants will be enrolled in a Pelvic Floor Muscle Training (PFMT) program using the action observation method accompanied by metaphorical imagery. This program will be administered over 12 weeks, consisting of twice-weekly group sessions lasting 45-50 minutes each. The exercise content is identical for both groups. However, during the sessions for this specific group, metaphor-themed visuals will be projected onto a screen, and participants will be given the instruction: 'Perform the movement by imagining it as shown in the visual.' To enhance physical participation and motivation, verbal cues and positive reinforcement will be provided by the physiotherapist. The exercises and the corresponding metaphors will be updated on a weekly basis. All sessions will be supervised by a physiotherapist in small groups of five participants.

Pelvic Floor Muscle Training via Action Observation Therapy

Eligibility Criteria

• Age: 65 Years - 80 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Diagnosed with stress or stress-predominant mixed urinary incontinence by a physician
• Women aged 65 years and older
• Literate in Turkish to understand, interpret, and answer the questionnaires
• Scoring 24 or higher on the Mini-Mental State Examination (MMSE)
• Able to walk independently without the use of any walking aids (assistive devices)
• Having signed the informed consent form

You may not qualify if:

• Received pelvic floor muscle training within the past 6 months
• Presence of fecal incontinence
• Current genitourinary infection or use of medication for urinary incontinence
• History of urinary incontinence surgery or presence of symptomatic pelvic organ prolapse
• Presence of neurological, orthopedic, psychiatric, hematological, or cardiovascular conditions that would preclude participation in exercise
• Body mass index (BMI) ≥ 25 kg/m²
• Hearing or visual impairments that would negatively affect participation
• Presence of hematuria, urethral and/or bladder fistula, or a history of pelvic surgery

Sponsors & Collaborators

• Fenerbahce University: lead

Study Sites (1)

Fenerbahce University Department of Physiotherapy and Rehabilitation

Istanbul, 34758, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Urinary Incontinence

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

Central Study Contacts

ARZU ÖZDİNÇLER, Prof

CONTACT

+90 216 910 1907; arzu.ozdincler@fbu.edu.tr

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PROF DR

Study Record Dates

• First Submitted: April 20, 2026
• First Posted: April 27, 2026
• Study Start: March 19, 2025
• Primary Completion: April 27, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: April 27, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share

Locations

TU (1)