Development and reproducible description of a multimodal physiotherapy intervention for pelvic floor health: a methodological report

Abstract

Female pelvic floor disorders are frequently managed through interventions focused on pelvic floor muscle training (PFMT). However, pelvic floor function is increasingly recognised as being influenced by the interaction between breathing, posture, movement, and lumboabdominopelvic control. Despite growing interest in multimodal approaches, few physiotherapy interventions have been described in sufficient detail to enable reproducibility, implementation, and clinical translation. This methodological report describes the rationale, development, and reproducible structure of a multimodal physiotherapy intervention for pelvic floor health based on postural, respiratory, and lumboabdominopelvic motor control principles. The intervention was originally developed and implemented in a controlled doctoral study involving 84 healthy nulliparous women (42 allocated to the intervention group and 42 to the control group) aged 18–25 years without pelvic floor dysfunction. It comprised a 12-week progressive programme combining three individual supervised learning sessions, 10 weeks of face-to-face group-based practice, and autonomous home-based practice through a structured sequence of postural and respiratory exercises. Throughout the programme, common principles of axial elongation, neutral pelvic alignment, costal expansion, coordinated pelvic floor and abdominal muscle control, and progressive postural adaptation were maintained across changing body configurations. This paper provides a detailed and reproducible description of the intervention to facilitate replication and future evaluation in physiotherapy practice and research. The intervention also includes predefined safety considerations and exercise adaptations to accommodate individual participant needs. This methodological report provides a comprehensive and reproducible description of a detailed multimodal physiotherapy intervention aimed at facilitating replication, reproducibility, and future evaluation in clinical and research settings.