Semi-supervised Telerehabilitation Exercise Program for Pelvic Floor Function in Pregnant Women with Gestational Diabetes Mellitus: A Randomized Controlled Clinical Trial.

INTRODUCTION

Pelvic floor dysfunctions (PFD) are common during pregnancy, and the metabolic stress of Gestational Diabetes Mellitus (GDM) may exacerbate this condition. Supervised muscle training is an option that might be effective for treating PFD. This study aimed to evaluate the effects of a semi-supervised exercise program, delivered via telerehabilitation, on pelvic floor function in pregnant women with GDM.

METHODS

A randomized, controlled, blinded clinical trial was conducted with participants allocated into an Exercise Group (EG; n=20) and a Control Group (CG; n=20). The EG performed an exercise protocol (aerobic, global strength, and pelvic floor muscle-specific training) for 10-20 weeks, with telemonitoring via smartphone. The CG received educational booklets. Pelvic floor muscle function, PFD symptoms and impacts, and sexual function were assessed before and after the intervention. Perceived global improvement was measured at the end of the study.

RESULTS

Although no between-group differences were observed post-intervention for the overall sample, the stratified analysis of participants with urinary incontinence (UI) revealed a significant time-by-group interaction for the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) (p = 0.007). Among women with UI, post-intervention between groups comparisons indicated mean differences of 4.07 (IC95%: 1.03;7.11) for the ICIQ-SF, 14.51 (IC95%: 1.26;27.76) for the UDI, and 2.68 (IC95%: -19.21;24.57) for the UIQ. In this subgroup, the EG demonstrated a numeric significant reduction in urinary discomfort and a protective effect against worsening UI severity compared with the CG.

CONCLUSION

A semi-supervised telerehabilitation program appears to be effective in reducing and preventing the progression of urinary symptoms in pregnant women with GDM and pre-existing urinary incontinence.