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NCT Number: NCT07551674

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

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.

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Key information

Conditions

Urinary Continence Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Lower Urinary Tract Symptoms Male Urogenital Diseases Pathological Conditions, Signs and Symptoms Signs and Symptoms Urinary Incontinence Urination Disorders Urogenital Diseases Urologic Diseases Urological Manifestations

Age range

65 year–80 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Fenerbahce University Department of Physiotherapy and Rehabilitation

Istanbul, 34758, Turkey (Türkiye)

Location status: Recruiting

Location contact

ARZU ÖZDİNÇLER, PROF

CONTACT

[email protected]

+90 216 910 1907

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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

Exclusion criteria

  • 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

Treatment and study plan

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 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.

Primary outcomes

  1. Mini-Mental State Examination

    Time frame: Baseline and after 12-weeks

  2. Pelvic Floor Distress Inventory

    Time frame: Baseline and after 12-weeks

  3. The Incontinence Severity Index

    Time frame: Baseline and after 12-weeks

  4. Movement Imagery Questionnaire-3

    Time frame: Baseline and after 12-weeks

Secondary outcomes

  1. Geriatric Self-Efficacy Index for Urinary Incontinence

    Time frame: Baseline and after 12-weeks

  2. Incontinence Quality of Life Questionnaire

    Time frame: Baseline and after 12-weeks

Study contacts

Contact information is provided by the study sponsor or research team.

ARZU ÖZDİNÇLER, Prof

CONTACT

[email protected]

+90 216 910 1907

Sponsors and collaborators

Lead sponsor

Fenerbahce University

Other

Registry information

Official study title

Investigation of the Effects of Pelvic Floor Muscle Training Applied Via Action Observation Method Accompanied by Metaphorical Imagery on Urinary Incontinence in Geriatric Women

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Apr 27, 2026
Registry last updated
May 11, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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