The effectiveness of an online exercise program on urinary incontinence of postpartum women: a quasi-experimental study

Abstract

<p><i>Objective:</i> To assess the effectiveness of a six‑week online exercise program on self‑assessed urinary incontinence (UI) symptoms and their impact on daily life among postpartum women immediately and six months after the intervention.<br></p><p><i>Methods:</i> A quasi-experimental pre-post design without a control group was used. Participants (n = 297) completed a six-week online exercise program focused on core and pelvic floor strengthening. Data were collected via electronic questionnaires at baseline, post-intervention, and six months later. UI symptoms were measured with the UDI-6 and symptoms impact on daily life with the IIQ-7. Changes across timepoints were analyzed using linear mixed models. Attrition increased across measurement points, with 89 women completing the six‑month follow‑up questionnaire.<br></p><p><i>Results:</i> UI symptoms decreased statistically significantly over time (p < 0.001) from baseline (mean 18.8; 95% CI 16.9, 20.7) to posttest (13.2; 95% CI 11.1, 15.4). At the 6-month follow-up, the scores had increased slightly (14.1; 95% CI 11.4, 16.9) but were still lower than at the baseline. For the perceived impact of UI on daily activities, the overall change was not statistically significant (p = 0.269). Mean (95% CI) IIQ-7 scores were 8.5 (6.9, 10.0) at baseline, 6.6 (4.7, 8.5) at posttest, and 6.7 (3.9, 9.4) at 6‑month follow‑up. Time since childbirth, BMI, mode of birth, and dysfunctions or symptoms related to pelvic floor and core muscles were associated with variation in studied outcomes.<br></p><p><i>Conclusion:</i> A six‑week self‑directed online exercise program was associated with a reduction in postpartum UI symptoms, with improvements largely maintained at six months. Individual characteristics were associated with symptom severity and responsiveness, highlighting the need for tailored postpartum rehabilitation and further controlled studies.<br></p>