Hypothesis / aims of study
Overactive pelvic floor muscles are associated with a range of symptoms including pelvic pain, dyspareunia, urinary urgency and frequency, and obstructed defecation. These symptoms frequently overlap across urological, gynaecological and colorectal domains and are commonly managed through pelvic health physiotherapy. Access to specialist pelvic health physiotherapy services is often limited by waiting lists and service capacity.
Digital physiotherapy resources may support patient education, facilitate early engagement with pelvic floor muscle relaxation strategies, and improve readiness for physiotherapy intervention.
The aim of this study was to evaluate the clinical implementation, patient engagement, and patient-reported outcomes of a digital multimodal physiotherapy programme designed to support pelvic floor muscle relaxation and self-management when delivered alongside routine pelvic health physiotherapy.
Study design, materials and methods
A digital pelvic floor muscle relaxation programme was implemented within a specialist pelvic health physiotherapy service in May 2025 and delivered via an online learning platform as an adjunct to routine physiotherapy care. Data were collected from patients who enrolled between May 2025 and March 2026.
The programme included four components: (1) educational material explaining overactive pelvic floor muscles; (2) written guidance on pelvic floor muscle relaxation techniques; (3) video demonstrations of exercises promoting pelvic floor muscle relaxation; and (4) guided audio relaxation focusing on pelvic floor awareness and whole-body relaxation.
Patients were invited to access the programme when overactive pelvic floor muscles were identified during assessment, or where relaxation strategies were indicated prior to initiation of strengthening.
Programme engagement data were collected via the platform. Patient-reported outcomes and experience were evaluated using a structured anonymous questionnaire. Descriptive analysis of engagement and outcome data was performed.
Results
A total of 219 patients enrolled in the programme, with 156 completing the course, representing a 71% completion rate. Survey responses were obtained from 56 participants (26% response rate).
Following participation, 89.3% of respondents reported symptom improvement (slight 21.4%, moderate 35.7%, significant 26.8%, symptoms resolved 5.4%), with 7.1% reporting no change. A further 3.6% reported the question as not applicable. Reported symptoms spanned bladder, bowel, sexual and pain domains, reflecting the multisystem presentation of overactive pelvic floor muscles.
Prior to participation, 92.8% of respondents reported low confidence (scores 1–2/5) in managing their symptoms. Following the programme, 94.6% reported moderate to high confidence (scores 3–5).
Overall, 89.1% reported improved understanding of their symptoms, and 84% rated the programme as very or extremely helpful as part of their physiotherapy care.
Estimated clinician time displaced per patient was approximately 30 minutes, equating to approximately 110 hours of clinical capacity across the cohort (n = 219).
Interpretation of results
This clinical evaluation demonstrates that a digital multimodal physiotherapy programme can be feasibly integrated into pelvic health physiotherapy care, achieving high patient engagement and positive patient-reported outcomes.
These findings suggest a role for digital physiotherapy in supporting early behavioural change, reinforcing therapeutic input between consultations, and improving patient readiness for physiotherapy intervention. Such approaches may enhance service efficiency and support patients while awaiting specialist care.
This evaluation was conducted as a service evaluation without a control group and utilised non-validated outcome measures. The survey response rate of 26% may introduce response bias, with findings more likely to reflect the experiences of engaged programme users, limiting generalisability.
Concluding message
A digital multimodal physiotherapy programme delivered alongside routine pelvic health physiotherapy demonstrated high completion rates, strong patient satisfaction, and positive patient-reported outcomes.
Digital physiotherapy programmes may represent a scalable approach to supporting pelvic floor muscle relaxation and self-management, with potential applications in triage support, waiting list management, and pre-assessment preparation within pelvic health services. Further research is warranted to evaluate effectiveness and integration within multidisciplinary pelvic health pathways.