{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:37:35Z","timestamp":1790717855593,"version":"4.1.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005326","name":"Yale University","doi-asserted-by":"publisher","award":["Yale Women Faculty Forum"],"award-info":[{"award-number":["Yale Women Faculty Forum"]}],"id":[{"id":"10.13039\/100005326","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>The number of patients who suffer from pelvic floor disorders increases with age and can have a significant impact on quality of life. The first-line treatment for these different disorders includes pelvic floor rehabilitation. However, there are high rates of non-compliance with completing the recommended duration of treatment due to delays in appointments and time constraints. Thus, the primary goal of this study is to evaluate the feasibility and acceptability of an online eight-week video-based pelvic floor muscle therapy program. A secondary goal is determining whether the treatment can improve quality of life and symptoms. This study is a registry-based pilot single-arm prospective trial (NCT06689891: Video-Based Pelvic Floor Muscle Therapy). A single-arm design was utilized because our primary aim was to assess feasibility rather than comparative efficacy. Methodical guidance recommends a single-arm approach when outcomes focus on process measures instead of hypothesis testing. This design allows us to evaluate whether the intervention can be delivered as intended, establish feasibility before a larger trial, and maintain flexibility for modification without compromising a control group. Eligible participants will be offered the online program as an alternative to in-person pelvic floor rehabilitation. Primary timepoints include a pre-intervention in-person visit with a licensed pelvic floor therapist and the 8-week video-based pelvic floor muscle therapy program. There will be a midpoint evaluation followed by a post-intervention visit with the same pelvic floor therapist, where participants will be graded on their ability to complete the various exercises to assess efficacy. A survey assessing the online-based program\u2019s usability will be conducted post-intervention. Patient-reported outcome measures, including quality of life and symptom changes, will be collected pre-, mid-, and post-intervention. As this is a pilot trial, the goal is to establish the acceptability and feasibility of a video-based pelvic floor muscle therapy program as an alternative to in-person treatment.<\/jats:p>","DOI":"10.1371\/journal.pone.0329883","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T17:32:42Z","timestamp":1761327162000},"page":"e0329883","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Video-based pelvic floor muscle therapy for patients with pelvic floor disorders: A Protocol for a prospective single-arm pilot and feasibility study"],"prefix":"10.1371","volume":"20","author":[{"given":"Samantha M.","family":"Linhares","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7444-3045","authenticated-orcid":true,"given":"Madeline L.","family":"D\u2019Aquila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt S.","family":"Schultz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne K.","family":"Mongiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,24]]},"reference":[{"issue":"1","key":"pone.0329883.ref001","doi-asserted-by":"crossref","first-page":"9878","DOI":"10.1038\/s41598-022-13501-w","article-title":"Prevalence of pelvic floor disorders in adult women being seen in a primary care setting and associated risk factors","volume":"12","author":"KA Kenne","year":"2022","journal-title":"Sci Rep"},{"issue":"11","key":"pone.0329883.ref002","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1001\/jama.300.11.1311","article-title":"Prevalence of symptomatic pelvic floor disorders in US women","volume":"300","author":"I Nygaard","year":"2008","journal-title":"JAMA"},{"issue":"2","key":"pone.0329883.ref003","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1002\/ijgo.14019","article-title":"Prevalence and severity of pelvic floor disorders in pregnant and postpartum women","volume":"158","author":"S Palmieri","year":"2022","journal-title":"Int J Gynaecol Obstet"},{"issue":"21","key":"pone.0329883.ref004","doi-asserted-by":"crossref","first-page":"3578","DOI":"10.3390\/cancers16213578","article-title":"Association Between Chemotherapy-Induced Peripheral Neuropathy and Low Anterior Resection Syndrome","volume":"16","author":"SM Linhares","year":"2024","journal-title":"Cancers (Basel)"},{"key":"pone.0329883.ref005","doi-asserted-by":"crossref","first-page":"1503410","DOI":"10.3389\/fsurg.2024.1503410","article-title":"Coding the issue: low anterior resection syndrome following rectal cancer treatment","volume":"11","author":"CN Fick","year":"2024","journal-title":"Front Surg"},{"issue":"3","key":"pone.0329883.ref006","first-page":"218","article-title":"Colorectal surgeon practice patterns of low anterior resection syndrome after rectal cancer treatment","volume":"33","author":"NA Coppersmith","year":"2025","journal-title":"Support Care Cancer"},{"issue":"3","key":"pone.0329883.ref007","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s00384-017-2954-x","article-title":"Treatment possibilities for low anterior resection syndrome: a review of the literature","volume":"33","author":"A Dulskas","year":"2018","journal-title":"Int J Colorectal Dis"},{"issue":"3","key":"pone.0329883.ref008","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1055\/s-0034-1384662","article-title":"Pelvic floor rehabilitation in the treatment of fecal incontinence","volume":"27","author":"KM Scott","year":"2014","journal-title":"Clin Colon Rectal Surg"},{"key":"pone.0329883.ref009","article-title":"Pelvic floor rehabilitation after rectal cancer surgery: A multicenter randomized clinical trial (FORCE trial)","author":"J van der Heijden","year":"2022","journal-title":"LWW"},{"issue":"3","key":"pone.0329883.ref010","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.dld.2013.11.002","article-title":"Perineal retraining improves conservative treatment for faecal incontinence: a multicentre randomized study","volume":"46","author":"H Damon","year":"2014","journal-title":"Dig Liver Dis"},{"issue":"1","key":"pone.0329883.ref011","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1002\/nau.20803","article-title":"Management of fecal incontinence in adults","volume":"29","author":"Conservative Management of Fecal Incontinence in Adults Committee of the International Consultation on Incontinence","year":"2010","journal-title":"Neurourol Urodyn"},{"issue":"4","key":"pone.0329883.ref012","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1002\/nau.22700","article-title":"Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a short version Cochrane systematic review with meta-analysis","volume":"34","author":"C Dumoulin","year":"2015","journal-title":"Neurourol Urodyn"},{"issue":"3","key":"pone.0329883.ref013","article-title":"Adherence to pelvic floor physical therapy referrals in women with fecal incontinence","volume":"28","author":"JH Ross","year":"2022","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"2","key":"pone.0329883.ref014","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/SPV.0000000000000732","article-title":"Compliance with pelvic floor physical therapy in patients diagnosed with high-tone pelvic floor disorders","volume":"27","author":"KL Woodburn","year":"2021","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"6","key":"pone.0329883.ref015","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.pmrj.2017.11.008","article-title":"Attendance at prescribed pelvic floor physical therapy in a diverse, urban urogynecology population","volume":"10","author":"MB Shannon","year":"2018","journal-title":"PMR"},{"issue":"7","key":"pone.0329883.ref016","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1002\/nau.22796","article-title":"2014 consensus statement on improving pelvic floor muscle training adherence: International Continence Society 2011 State-of-the-Science Seminar","volume":"34","author":"C Dumoulin","year":"2015","journal-title":"Neurourol Urodyn"},{"issue":"2","key":"pone.0329883.ref017","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2011.03.029","article-title":"Barriers to pelvic floor physical therapy utilization for treatment of female urinary incontinence","volume":"205","author":"BB Washington","year":"2011","journal-title":"Am J Obstet Gynecol"},{"issue":"6","key":"pone.0329883.ref018","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/SPV.0000000000000401","article-title":"Barriers to Pelvic Floor Physical Therapy Regarding Treatment of High-Tone Pelvic Floor Dysfunction","volume":"23","author":"D Zoorob","year":"2017","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"12","key":"pone.0329883.ref019","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1097\/SPV.0000000000001510","article-title":"Telehealth in a Pelvic Floor Physical Therapy Clinic: A Retrospective Cohort Study","volume":"30","author":"CM Ter Haar","year":"2024","journal-title":"Urogynecology (Phila)"},{"key":"pone.0329883.ref020","author":"ZS Aloul","year":"2025"},{"issue":"10","key":"pone.0329883.ref021","first-page":"589","article-title":"Pelvic floor muscle training delivered via telehealth to treat urinary and\/or faecal incontinence after gynaecological cancer surgery: a single cohort feasibility study","volume":"31","author":"R Brennen","year":"2023","journal-title":"Support Care Cancer"},{"key":"pone.0329883.ref022","doi-asserted-by":"crossref","first-page":"108376","DOI":"10.1016\/j.maturitas.2025.108376","article-title":"The feasibility and effects of a telehealth-delivered physical therapy program for postmenopausal women with urinary incontinence: A pilot mixed-methods study","volume":"197","author":"K-Y Lin","year":"2025","journal-title":"Maturitas"},{"key":"pone.0329883.ref023","unstructured":"Utilizing remote, video-based pelvic floor muscle therapy for the management of low anterior resection syndrome in rectal cancer patients: a feasibility trial. https:\/\/clinicaltrials.gov\/study\/NCT06689891. 2024."},{"key":"pone.0329883.ref024","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/1471-2288-13-104","article-title":"An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database","volume":"13","author":"SAM Billingham","year":"2013","journal-title":"BMC Med Res Methodol"},{"issue":"1","key":"pone.0329883.ref025","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/MLR.0000000000001664","article-title":"Guidelines for Designing and Evaluating Feasibility Pilot Studies","volume":"60","author":"JA Teresi","year":"2022","journal-title":"Med Care"},{"issue":"13","key":"pone.0329883.ref026","doi-asserted-by":"crossref","first-page":"4800","DOI":"10.3390\/jcm14134800","article-title":"Training Interventions Used in Postmenopausal Women to Improve Pelvic Floor Muscle Function Related to Urinary Continence-A Systematic Review","volume":"14","author":"M Piernicka","year":"2025","journal-title":"J Clin Med"},{"issue":"3","key":"pone.0329883.ref027","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/JWH.0000000000000202","article-title":"Exercise interventions to improve pelvic floor muscle functioning in older women with urinary incontinence: a systematic review","volume":"45","author":"A Fricke","year":"2021","journal-title":"J Women\u2019s Health Physical Therapy"},{"issue":"2","key":"pone.0329883.ref028","article-title":"Factors that influence the provision of home-based rehabilitation services for people needing rehabilitation: a qualitative evidence synthesis","volume":"2","author":"M Velez","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"pone.0329883.ref029","first-page":"488","article-title":"The effect of a supervised exercise trial on exercise adherence among African American Men: a pilot study","volume":"103","author":"TR Taylor","year":"2011","journal-title":"J Natl Med Assoc"},{"issue":"1","key":"pone.0329883.ref030","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12966-023-01535-w","article-title":"Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses","volume":"20","author":"A Santos","year":"2023","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"8","key":"pone.0329883.ref031","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3444","article-title":"A systematic review of adherence to physical activity interventions in individuals with type 2 diabetes","volume":"37","author":"CS MacDonald","year":"2021","journal-title":"Diabetes Metab Res Rev"},{"issue":"7","key":"pone.0329883.ref032","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1080\/10447318.2018.1455307","article-title":"The System Usability Scale: Past, Present, and Future","volume":"34","author":"JR Lewis","year":"2018","journal-title":"Int J Human\u2013Computer Interaction"},{"key":"pone.0329883.ref033","unstructured":"Brooke J. SUS-A quick and dirty usability scale. Usability evaluation in industry. 1996;189(194):4\u20137."},{"issue":"8","key":"pone.0329883.ref034","doi-asserted-by":"crossref","DOI":"10.2196\/37290","article-title":"System Usability Scale Benchmarking for Digital Health Apps: Meta-analysis","volume":"10","author":"M Hyzy","year":"2022","journal-title":"JMIR Mhealth Uhealth"},{"issue":"2","key":"pone.0329883.ref035","article-title":"SUS: a retrospective","volume":"8","author":"J Brooke","year":"2013","journal-title":"J Usability Studies"},{"issue":"4","key":"pone.0329883.ref036","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/SPV.0b013e31829950e5","article-title":"Pelvic floor muscle training for urinary incontinence: a comparison of outcomes in premenopausal versus postmenopausal women","volume":"19","author":"C Betschart","year":"2013","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"3","key":"pone.0329883.ref037","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-Item short-form health survey: construction of scales and preliminary tests of reliability and validity","volume":"34","author":"J Ware","year":"1996","journal-title":"Med Care"},{"issue":"1","key":"pone.0329883.ref038","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/BF02050307","article-title":"Etiology and management of fecal incontinence","volume":"36","author":"JM Jorge","year":"1993","journal-title":"Dis Colon Rectum"},{"issue":"12","key":"pone.0329883.ref039","doi-asserted-by":"crossref","first-page":"2101","DOI":"10.1007\/s00192-019-03945-6","article-title":"Strong agreement between interview-obtained and self-administered Wexner and St. Mark\u2019s scores using a single questionnaire","volume":"30","author":"S Norderval","year":"2019","journal-title":"Int Urogynecol J"},{"issue":"9","key":"pone.0329883.ref040","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1080\/003655299750025327","article-title":"Psychometric validation of a constipation symptom assessment questionnaire","volume":"34","author":"L Frank","year":"1999","journal-title":"Scand J Gastroenterol"},{"issue":"1","key":"pone.0329883.ref041","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/SPV.0000000000000817","article-title":"Measuring pelvic floor disorder symptoms using patient-reported instruments: proceedings of the consensus meeting of the pelvic floor consortium of the american society of colon and rectal surgeons, the international continence society, the american urogynecologic society, and the society of urodynamics, female pelvic medicine and urogenital reconstruction","volume":"26","author":"LG Bordeianou","year":"2020","journal-title":"Female Pelvic Med Reconstr Surg"},{"issue":"4","key":"pone.0329883.ref042","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1002\/nau.20041","article-title":"ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence","volume":"23","author":"K Avery","year":"2004","journal-title":"Neurourol Urodyn"},{"issue":"6","key":"pone.0329883.ref043","first-page":"1055","article-title":"Further properties of the pelvic organ prolapse symptom score: minimally important change and test-retest reliability","volume":"29","author":"S Hagen","year":"2010","journal-title":"Neurourol Urodyn"},{"issue":"1","key":"pone.0329883.ref044","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/j.1471-0528.2008.01903.x","article-title":"Psychometric properties of the pelvic organ prolapse symptom score","volume":"116","author":"S Hagen","year":"2009","journal-title":"BJOG"},{"issue":"4","key":"pone.0329883.ref045","first-page":"685","article-title":"Validity and reliability of the international consultation on incontinence questionnaire-urinary incontinence short form and its correlation with urodynamic findings","volume":"9","author":"S Hajebrahimi","year":"2012","journal-title":"Urol J"},{"issue":"11","key":"pone.0329883.ref046","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1001\/jamainternmed.2021.5450","article-title":"Effectiveness and ethics of incentives for research participation: 2 randomized clinical trials","volume":"181","author":"SD Halpern","year":"2021","journal-title":"JAMA Intern Med"},{"issue":"4","key":"pone.0329883.ref047","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0267534","article-title":"The effectiveness of incentives for research participation: A systematic review and meta-analysis of randomized controlled trials","volume":"17","author":"B Abdelazeem","year":"2022","journal-title":"PLoS One"},{"issue":"3","key":"pone.0329883.ref048","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1007\/s11606-022-07690-3","article-title":"Access to care among adults with limited english proficiency","volume":"38","author":"N Ramirez","year":"2023","journal-title":"J Gen Intern Med"},{"issue":"6","key":"pone.0329883.ref049","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1001\/jamasurg.2023.0198","article-title":"Effect of multimodal prehabilitation on reducing postoperative complications and enhancing functional capacity following colorectal cancer surgery: the prehab randomized clinical trial","volume":"158","author":"CJL Molenaar","year":"2023","journal-title":"JAMA Surg"},{"issue":"4","key":"pone.0329883.ref050","doi-asserted-by":"crossref","first-page":"100097","DOI":"10.1016\/j.soi.2024.100097","article-title":"Pelvic Floor Physical Therapy Prehabilitation (PrePFPT) for the prevention of low anterior resection syndrome","volume":"1","author":"NA Coppersmith","year":"2024","journal-title":"Surgical Oncology Insight"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0329883","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T17:32:51Z","timestamp":1761327171000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0329883"}},"subtitle":[],"editor":[{"given":"Mehrnaz","family":"Kajbafvala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,24]]},"references-count":50,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0329883","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,24]]}}}