Investigation of Core Stabilization Strength and Pelvic Floor Functions in Patients with Primary Sjögren's Syndrome: A Case-Control Study


Akar B., Kabul E., Calik B. B., Bozcuk S., Cobankara V.

INTERNATIONAL UROGYNECOLOGY JOURNAL, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2026
  • Doi Number: 10.1007/s00192-025-06467-6
  • Journal Name: INTERNATIONAL UROGYNECOLOGY JOURNAL
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Keywords: Muscle, Quality of life, Questionnaire, Urinary incontinence
  • Uşak University Affiliated: Yes

Abstract

Introduction and Hypothesis: This study was aimed at assessing core stabilization strength and pelvic floor function in patients with primary Sjögren’s syndrome (pSS), as well as identifying factors associated with pelvic floor functionality and that serve as potential predictors. Methods: This study was planned as a case–control study. Healthy controls consisted of companions of patients with pSS and friends of the authors. A visual analog scale (VAS; to assess vaginal dryness and general pain intensity), McGill Static endurance tests (trunk flexors/extensors endurance, lateral bridge tests), the Health Assessment Questionnaire (HAQ), the Pelvic Floor Distress Inventory-20 (PFDI-20), the Incontinence Impact Questionnaire-7 (IIQ-7), and the Sexual Quality of Life-Female, Biopsychosocial Questionnaire (BETY-BQ) were evaluated. The PFDI-20 consists of three questionnaires: the Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), the Colorectal-Anal Distress Inventory-8 (CRADI-8), and the Urinary Distress Inventory-6 (UDI-6). Results: A total of 29 individuals with pSS and 27 healthy controls were included. In a group comparison, there was a difference in HAQ (p < 0.001), PFDI-20 (p < 0.001), POPDI-6 (p < 0.001), CRADI-8 (p < 0.001), UDI-6 (p < 0.001), IIQ-7 (p < 0.001), and BETY-BQ (p < 0.001) in favor of the healthy group. In pSS, the PFDI-20 has a very strong correlation with the IIQ-7 (r 0.864, p < 0.001); a strong correlation with the HAQ (r 0.668, p < 0.001), the BETY-BQ (r 0.667, p < 0.001); a moderate correlation with trunk flexor endurance (r −0.579, p = 0.003), lateral bridge tests (right) (r −0.479, p = 0.018), VAS-general pain intensity (r 0.440, p = 0.017); a weak correlation with VAS-vaginal dryness (r 0.395, p = 0.034). In regression analysis, the IIQ-7 was the strongest predictor of pelvic floor functionality in pSS (ß = 0.563; p < 0.001). Conclusions: No group differences were found in core endurance or sexual quality of life. Compared with controls, pSS patients had reduced general and pelvic floor function, greater urinary incontinence, and poorer biopsychosocial status, with urinary incontinence being the strongest predictor of pelvic floor dysfunction. Trial Registration: This study was registered with ClinicalTrials.gov under the number NCT06879444.