Pelvic Floor Muscle Training and Neuromuscular Performance in Women's Rugby

NCT07757633 | Recruiting

• 1 other identifier: G-2504-06806
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief 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. 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.

Conditions

Urinary Incontinence (UI); Pelvic Floor Disorders

Keywords

Women athletes; female athletes; rugby; pelvic floor muscle training; urinary incontinence; stress urinary incontinence; pelvic health; force plates; neuromuscular performance; remote

Outcome Measures

Primary Outcomes (1)

• 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.

  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

  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

  Baseline and immediately after the intervention (8 weeks)

• Change in countermovement jump height

  Baseline and immediately after the intervention (8 weeks)

• Change in maximal isometric squat peak force

  Baseline and immediately after the intervention (8 weeks)

• Change in Reactive Strength Index during the countermovement rebound jump

  Baseline and immediately after the intervention (8 weeks)

Study Arms (2)

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.

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.

Interventions

Rugby-Tailored Pelvic Floor Muscle Training Programme BEHAVIORAL

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.

Rugby-Tailored Pelvic Floor Muscle Training Programme

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• 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.

You may not qualify if:

• 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.

Sponsors & Collaborators

• Universidad de Granada: lead
• World Rugby Research Unit: collaborator

Study Sites (1)

Faculty of Sport Sciences, University of Granada

Granada, 18071, Spain

RECRUITING

Related Publications (3)

• 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.

  PMID: 40650437 BACKGROUND

• Donnelly 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.

  PMID: 39639650 BACKGROUND

• Dominguez-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.

  PMID: 41989514 BACKGROUND

MeSH Terms

Conditions

Urinary Incontinence; Pelvic Floor Disorders; Urinary Incontinence, Stress

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; Pregnancy Complications

Central Study Contacts

Javier Courel-Ibáñez, PhD

CONTACT

+34952 69 87 00; courel@ugr.es

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: The behavioural intervention cannot be masked to participants Randomization is generated by an independent researcher and allocation is concealed using sealed, opaque envelopes.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Two parallel groups: rugby-tailored pelvic floor muscle training plus usual rugby training versus usual rugby training without study pelvic floor muscle training.

Study Record Dates

• First Submitted: August 2, 2026
• First Posted: August 11, 2026
• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): December 1, 2026
• Last Updated: August 11, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

ES (1)