## 4 Discussion  
The results of this study demonstrate that a structured two-month AHT program significantly improves PFM strength in EG, with robust increases in MVC and related metrics such as ME. These findings align with previous research emphasizing the benefits of AHT in addressing pelvic floor dysfunctions, including urinary incontinence (UI) and diminished PFM tone and/or strength [3, 7]. The observed improvements in PFM strength are consistent with the physiological mechanisms proposed for AHT, which combine postural realignment and diaphragmatic breathing to stimulate deep muscle fibers [4]. The perineum should be understood as a muscular group with respiratory function, with its spinal control in the respiratory center. Proprioceptive control allows for a correct perineal block and facilitates a greater understanding of the impact of one's own forces. At the same time, myostatic reflex plays a key role in the damping capacity, which might be potentiated by a specific breathing. The mean increases in MVC recorded in this study echo findings from [PERSON] et al. [7], who reported significant gains in muscle tone following the same AHT intervention. Furthermore, the improvements in ME suggest that AHT not only enhances peak performance but also facilitates sustained functional capacity, which is critical for everyday activities requiring core stability as well as reducing UI. UI remains a significant concern for women's quality of life, affecting their physical, emotional, and social well-being [1]. The gains in PFM strength found in the present study have direct implications for UI management. Increased muscle strength contributes to better urethral closure during activities that elevate intra-abdominal pressure, such as coughing, sneezing, or exercising. Moreover, higher strength levels and increased thickness of the levator ani muscle can contribute to reducing prolapses and improving the positioning and support of various pelvic organs [25, 26]. This study corroborates AHT as a viable alternative or complement to traditional PFMT methods. The effectiveness of AHT for PFM training has been explored in recent literature, but its relative efficacy compared to conventional PFM training methods, such as Kegel exercises, remains a subject of debate. A study by [PERSON] et al. [5] compared HE combined with traditional PFM training against PFM training alone in women with pelvic organ prolapse. The results indicated that both groups showed significant improvements in PFM function, as measured by MVC and muscle activation, with no additional benefit observed when HE were added to PFM training. Similarly, [PERSON] et al. [27] found that a six-week hypopressive training program significantly improved PFM strength and reduced pelvic organ prolapse symptoms. On the other hand, systematic reviews on PFM training, such as [PERSON] et al. [28], indicate that various physiotherapy methods, including biofeedback, vaginal cones, and coactivation of abdominal muscles, show improvements in PFM contraction, but none have been definitively superior to the others. This suggests that HE may offer an alternative, rather than a replacement, to traditional PFM training, particularly for individuals seeking a postural and breathing-based approach. While our study focused on evaluating the effects of AHT on PFM strength, further research is warranted to directly compare its efficacy to Kegel exercises in terms of long-term functional benefits, such as urinary incontinence prevention and pelvic organ support. Moreover, several advantages of AHT protocols can be pointed out compared to conventional PFMT. AHT emphasis on reducing intra-abdominal pressure, which may mitigate the risk of hypertonicity, which is a common side effect of repetitive strength training and can impede relaxation and a normal function of the PFM, causing pain and sexual dysfunction, among others [29].