Comparative Impact of Hydrotherapy and Land-Based Exercise on Pelvic Floor Muscle Endurance in Pregnant Women

Pelvic floor muscles support the bladder, bowel, and reproductive organs and play an important role in maintaining pelvic floor function during pregnancy. Pregnancy can place increased demands on these muscles because of changes in body weight, posture, hormonal changes, and pressure on the pelvic floor.

Exercise during pregnancy may help maintain pelvic floor muscle function. Hydrotherapy provides exercise in water, where buoyancy can reduce the load on the body and may allow pregnant women to exercise with greater comfort. Land-based exercise is another commonly used approach for maintaining physical function during pregnancy. However, it is not clear whether hydrotherapy and land-based exercise are associated with different levels of pelvic floor muscle endurance.

This retrospective study will review existing clinical records of pregnant women who participated in hydrotherapy or land-based exercise. The researchers will compare the available pelvic floor muscle assessment findings between the two groups to determine whether pelvic floor muscle endurance differs between the exercise approaches.

The findings may provide information about the potential role of hydrotherapy and land-based exercise in maintaining pelvic floor muscle function during pregnancy. The results may also help physiotherapists make informed decisions when selecting exercise approaches for pregnant women.

Inclusion criteria

• Pregnant women aged 20-35 years, singleton pregnancy confirmed by ultrasound, gestational age between 18 and 32 weeks (second to early third trimester), absence of obstetric complications such as placenta previa, gestational diabetes or preeclampsia medical clearance from an obstetrician to participate in hydrotherapy and moderate physical activity, ability to understand and follow instructions, willingness to participate in regular exercise sessions and attend follow-up assessments for 6 weeks.

Exclusion criteria

• Age below 20 years or above 35 years, gestational age outside the 18-32week range, multiple pregnancy, obstetric complications such as placenta previa, uncontrolled gestational diabetes or pregnancy-induced hypertension, open wounds or infections contraindicating hydrotherapy, musculoskeletal conditions limiting safe participation in aquatic exercise, history of cardiovascular or respiratory disorders, fear of water or discomfort in aquatic environments, inability to complete follow-up evaluations or refusal to participate in the intervention period.