# Perceptions of a 'Pelvic-Floor Friendly' Group Exercise Class in Women with Urinary Incontinence
## 1 Introduction
The growing body of evidence suggests UI is an overlooked but significant barrier to women's PA, usually resulting in women having to withdraw from their preferred mode, or from all modes, of PA [30]. Group-based PA has been noted as a mode of PA that women find both enjoyable and rewarding, particularly due to the social opportunity group-based PA fosters; however, as discussed, it is also a mode from which women are likely to withdraw if they experience UI, due to the stigma and fear of leaking in front of others [30; 53]. Understanding how women's preferred modes of PA can be suitably modified to help minimise UI risk would seem prudent, especially given the importance of enjoyment and social inclusion in forming motivation and habitual PA adherence and the long-term effects these have on older age. Whilst many PA interventions are aimed directly at older women, promoting PA and developing PA as a habit in midlife women could be particularly beneficial as the risk associated with many of the chronic diseases which burden women increases with the onset of menopause [6]. Social isolation, but not loneliness, appears to be a particularly useful factor to include in midlife PA interventions; [PERSON] et al. [38] suggest loneliness may be less of an issue in midlife due to this age group often reporting family commitments and pressures as a reason for physical inactivity and, as a result, familial relationships may negate feelings of loneliness but not those of social exclusion in midlife women. Family commitments are well known to be the reason midlife women are more likely to report \"being busy\" as a barrier to PA [39]; therefore, it may be that a group-based PA intervention which allows opportunities to socialise could present women with a 'time-saving' opportunity by combining PA and social needs, increasing the attractiveness of such an intervention to women who experience UI during PA and encouraging the attendance and building of habitual PA.  
No studies to date have examined the modification of individual design elements of a group-based PA intervention aimed at engaging women with UI or explored women with UI's perception of modifications made to a group-based PA intervention. It is, therefore, the intention of the current study to modify a'standard' dance-based group PA class using the evidence discussed above and to understand women's perceptions of the modifications made as well as their willingness to participate in a similarly designed PA class in the future. This study also sought to understand how the advertising of group exercise could be improved to encourage and improve PA participation in women who experience UI during PA. Therefore, this research aims to answer the following research question: does a tailored 'pelvic-floor friendly' group exercise class help increase PA participation in women with UI? Specifically, the study aims to:  
1. Determine if a 'pelvic-floor friendly' group exercise class can influence the motivation or intent of women with UI to participate in PA;
2. Explore women with UI's perceptions and feelings towards the design elements of a 'pelvic-floor friendly' group exercise class, including when combined with access to a women's specialist pelvic health physiotherapist;
3. Provide insight into the advertising of exercise programmes targeting women and how advertisements are perceived by women who experience UI when exercising.