A Mobile Application for Female Athletes With Pelvic Floor Dysfunctions (ACTITUD2.0)

Change in the pelvic floor strength according to the modified grading Oxford Scale (graded from 0 - minimal strength- to 5 points - maximal strength) after the intervention period and compared to the athletes from the rest of groups. To assess it, the evaluator will insert the first two phalanges of the second and third fingers smeared in lubricant gel with a gloved hand into the anterior third of the vaginal opening and will request a maximal voluntary contraction (MVC) by giving the command "contract the anus, do as if you wanted to hold a strong desire to void".

Change in the maximal voluntary contraction (MVC) according to the values of pressure collected by a manometer (in cmH20) after the intervention period and compared to the athletes from the rest of groups. To assess it, participants will perform a maximal contraction of pelvic floor musculature during 3 seconds (two trials with 30 seconds apart). The best trial (the highest pressure) will be collected.

Change in the vaginal pressure at rest (in cmH20) after the intervention period and compared to the athletes from the rest of groups. To assess it, the probe of the manometer will be covered with a lubricated condom and placed about 3.5 cm proximal to the vaginal introitus, without pain or discomfort. The air in the probe will be emptied before being inserted into the vagina introitus and vaginal pressure at rest will be registered.

Change in the proprioceptive error during a force sense test (Proprioception) according to the values of pressure collected by a manometer (in cmH20) after the intervention period and compared to the athletes from the rest of groups. To assess it, participants will perform a contraction of pelvic floor musculature at 50% of maximal voluntary contraction (MVC) (TARGET) during 3 seconds (two trials with 10 seconds apart). The difference between the average of the two trials and the target value will be the proprioceptive error (in %).

Change in the levator hiatus length (in mm) after the intervention period and compared to the athletes from the rest of groups. This variable will be assessed by using transperineal approach with transducer in longitudinal orientation, at three different functional situations: at rest, while participants perform a maximal voluntary contraction (MVC) of the pelvic floor musculature, and also at straining.

Change in the anorectal angle (in degrees) and pubourethral angle (in degrees) after the intervention period and compared to the athletes from the rest of groups. These variables will be assessed by using transperineal approach with transducer in longitudinal orientation, at three different functional situations: at rest, while participants perform a maximal voluntary contraction (MVC) of the pelvic floor musculature, and also at straining.

Change in the symmetry of the bladder base (in mm) at rest and bladder base displacement (in mm) while participants perform a maximal voluntary contraction (MVC) of the pelvic floor musculature and also during straining, after the intervention period and compared to the athletes from the rest of groups. These variables will be assessed by using a transabdominal approach with transducer, in transverse orientation.

Change in the maximal height that athletes reach with a vertical jump (in meters) after the intervention period and compared to the athletes from the rest of groups. To assess it, participants will perform a maximal countermovement jump (three trials with 60 seconds apart). It will be collected the best of the three trials.

Change in the maximal ground reaction forces during a vertical jump (in Newton) after the intervention period and compared to the athletes from the rest of groups. To assess it, participants will perform a maximal countermovement jump (three trials with 60 seconds apart). It will be collected the best of the three trials.

Change in self-reported pelvic floor symptoms regarding urinary incontinence, assessed through the International Consultation on Incontinence Questionnaire - Short form (ICIQ-SF) after the intervention period and compared to the athletes from the rest of groups. To this end, athletes will reply the proposed tool consisting of 3 questions, with a total score of 21 points. Scoring 0 points will mean that athletes do not have urinary incontinence; score between 1 and 21 will mean a progressively more severe urinary incontinence.

Change in self-reported sexual dysfunction symptoms (orgasm and pain domains of the Female Sexual Function Index - FSFI), after the intervention period and compared to the athletes from the rest of groups. The score of each domain is rated from 1 (the worst sexual function) to 15 points (the best sexual function)

Change in self-reported pelvic floor symptoms regarding ano-rectal incontinence, assessed through the Wexner Scale, after the intervention period and compared to the athletes from the rest of groups. To this end, athletes will reply the proposed tool consisting of 5 questions ranging from 0 (never incontinent) to 4 (always incontinent). A score of 0 points will mean that athletes do not have ano-rectal incontinence. Results in the score from 1 to 20 will mean ano-rectal incontinence progressively more severe.

It will be explore the change in quality of life due to the pelvic floor disorders symptoms (according to a scale from 0, no affection, to 10, maximal affection) after the intervention period and compared to the athletes from the rest of groups.

Percentage of exercises program sessions that athletes from experimental groups 1 and 2 completed during the 12 weeks of intervention, according to the number of proposed sessions (three times per week).