# Perceptions of a 'Pelvic-Floor Friendly' Group Exercise Class in Women with Urinary Incontinence
## 2 Materials and Methods
### Intervention  
A dance-based group exercise class was designed with the aid of a qualified dance and fitness group exercise instructor. The class was designed primarily to limit the risk of participants leaking urine and was based on Ballroom and Latin dance, but with all jumping and moves, which placed stress on the pelvic floor muscles, removed. A woman's pelvic floor specialist physiotherapist holding a fellowship with the Chartered Society of Physiotherapy was also consulted and made available throughout the study (online and in person), to guide decision-making and provide help to any participants requiring support during the group exercise class. Key characteristics of the class were altered from the 'norm' of common dance-based group exercise classes in the following ways as outlined below. A 'Reverse Instruction Method' was used; this consisted of low-impact movements forming the basis of the class instead of the normal high-impact dance moves from the outset that one might expect. This was important as it allowed the exercise instructor to suggest higher impact movements \"for those who feel safe to do them\", which could allow the participants an opportunity to assess the risk of increasing the intensity without fear of leaking or judgment if they could not do so. Wherever possible, medium intensity of exercise was maintained throughout the intervention class to maximise the \begin{table}
\begin{tabular}{l c c c} \hline \hline \multicolumn{1}{c}{**Characteristic**} & **Intervention Group (n = 6)** & **Control Group (n = 9)** & \multicolumn{1}{c}{_p-Value_} \\ \hline Age (Mean, SD) & 47.33, 11.37 & 45.55, 7.38 & \\ ICIQ Score (Mean, SD) & 11.16, 2.71 & 11.11, 2.67 & 0.97 \\ IPAQ Score (Mean, SD) & & & \\ - Vigorous activities last 7 days (\# of days) & 1.83, 1.94 & 1.88, 0.92 & 0.95 \\ - Vigorous activities last 7 days (minutes per day) & 30.83, 26.9 & 29.0, 7.4 & 0.85 \\ - Moderate activities last 7 days (\# of days) & 2.2, 0.83 & 2.75, 1.58 & 0.45 \\ - Moderate activities last 7 days (minutes per day) & 580, 42.66 & 48.75, 36.03 & 0.66 \\ - Walking last 7 days (no of days) & 4.66, 2.06 & 4.75, 2.49 & 0.94 \\ - Walking last 7 days (minutes per day) & 64.16, 43.63 & 75.1, 53.38 & 0.68 \\ - Sitting last 7 days (minutes per day) & 530.1, 235.20 & 448.80, 173.45 & 0.45 \\ \hline \hline \end{tabular} Note. ICIQ = Incontience Questionnaire Urinary Incontience; IPAQ—International Physical Activity Questionnaire.  
\end{table} 
Table 1: Baseline characteristics of the study population. exercise benefits given the time frame of the class. These changes and considerations were made based on evidence suggesting that participants often feel failure when group class instructors provide an \"easier\" exercise, particularly where the participant believes that the intensity is manageable, but the move itself is an issue (anything high impact or with legs apart, for example). This situation appears to be a reason why participants withdrew from the group PA environment. Therefore, it was decided to test whether reversing the normal method of instruction would prevent women from feeling this way and help them remain participatory. A group instructor was also sought with characteristics that participants report as a deterrent to group exercise, for example, being less likely to consider group exercise if the instructor was male due to feeling he would not understand the issues UI presented in the exercise environment. A female instructor was therefore enlisted to conduct this study's group class. The instructor was also required to be 35-59 years old, have experience with UI during exercise and be comfortable mentioning it in class. This decision was also informed by the screening procedure, where some participants reported they felt uncomfortable in front of younger instructors, even if they are female, and again, this was attributed to the perception that the instructor would not understand or consider UI's impact on the women's ability to perform certain exercises in class.