## 4 Discussion
This aspect is even more important when referring to the youth population due to the embarrassment that this type of consultation could cause them. Young female athletes do not seek help or treatment for SP symptoms. In a study by [PERSON] [37] 90% of young females with symptoms had not discussed it with anyone although they acknowledged that they would do SP exercises if they knew how. However, according to [PERSON] et al. [38] adult females were more likely to succeed in SP programs because they consulted more frequently and had high adherence to the programs. The exercise program proposed is also an important aspect to discuss. Unlike a strengthening exercise program focused on superficial muscle groups in other anatomical regions, the deep location of the pelvic floor muscular complex and its composition, with only 6% formed by voluntary contraction muscle fibers, make it impossible to demand an isolated part of this musculature. Instead, the proposed exercises were graded by modifying the posture and type of contraction that females should perform [39]. In this way, from the least to the most demanding, postures were as follows: lying down, quadruped, sitting, standing, and plank, due to the combination with core muscle activation [40]. Regarding the type of contraction, the combination of sustained contraction (5 s) with repeated short-duration contractions (1 s) and reduced resting time is frequently used for progressive overload [39]. Therefore, our program was designed to add progressive difficulty every two weeks by considering these components. We should also highlight that the proposed exercises are designed for female athletes, with previous experience to perform physical efforts to train and compete in any track and field modality. For instance, the plank position, a high-demanding exercise that activates and fatigues the lumbo-pelvic hip complex, is proposed from the third week to achieve the coactivation of pelvic floor muscles and other regional muscles. Although some studies name this combination as \"advanced\" pelvic floor muscle training, it is almost mandatory for females that train and compete in a sport like track and field [41]. It is worthy to state the autonomous character of the exercise program, where athletes independently perform the training exercises. To guide the participants of experimental groups, the smartphone application gave them detailed instructions about how to properly perform the exercises through multimedia resources. For example, prior to starting every session of exercises, they should ensure their correct pelvic floor contraction by using the Periform(r) probe, guided by a video. To facilitate the proper execution of the exercises and compensate for the non-presential professional supervision, participants from EG2 wore intravaginal biofeedback as guidance about their intravaginal pressure while performing the exercises [17]. Contrary to our hypothesis, we did not find any statistical difference compared to the rest of the groups, but certain trends in favor of EG2 and stronger effect sizes in a reduction in incontinence urinary score. Apart from the specific design of the exercise program, other differences in our proposal with the available options in the scientific literature is that the smartphone application allows female athletes to ask health professionals any question they have during the exercise program even from their homes. Also, a health professional may monitor participants and send updated multimedia information regarding the care of their pelvic floor structures. These aspects met the needs of an autonomous but tele-supervised exercise program and could be related to the high adherence observed in our study, in line with previous studies that proposed smartphone applications for pelvic floor training programs [42]. According to previous studies, among the most frequent factors related to poor adherence are lack of motivation and discipline, fatigue, lack of time, poor attention, and lack of feedback [43].