MoVo-guided Traditional Chinese Kegel Exercises for Preventing Postpartum Urinary Incontinence.

The goal of this clinical trial is to determine whether a prenatal exercise program integrating Liuzijue qigong with traditional levator ani training, guided by the MoVo (Motivation-Volition) theory and delivered via a supervised mobile application, can effectively prevent postpartum urinary incontinence and pelvic organ prolapse in pregnant women, compared with app-supervised conventional Kegel exercises and routine prenatal care. The main questions it aims to answer are: Does the integrated Liuzijue-and-levator-ani program reduce the incidence of postpartum urinary incontinence and prolapse more effectively than app-supervised Kegel exercises or routine care? Can the MoVo-based behavioural framework (motivation enhancement, action planning, and self-monitoring) improve long-term adherence to pelvic floor training during pregnancy and the postpartum period? What are the effects of the three interventions on pelvic floor muscle function, exercise self-efficacy, anxiety levels, and delivery outcomes? Researchers will compare three parallel groups: (1) the integrated Liuzijue-and-levator-ani exercise group, (2) the app-supervised conventional Kegel exercise group, and (3) the routine care control group receiving only verbal instruction on pelvic floor exercises during standard prenatal visits. All three groups will be followed from enrolment through 6 weeks postpartum to determine whether the culturally adapted mind-body intervention offers superior pelvic floor protection beyond app-delivered Kegel training and routine care. Participants will: Be enrolled in the third trimester and randomly assigned to one of the three groups. In the integrated exercise group, perform daily combined Liuzijue-and-levator-ani exercises via a supervised mobile app and attend periodic check-ins until 6 weeks postpartum. In the app-supervised Kegel group, perform daily conventional Kegel exercises via the same mobile app platform with the same supervision schedule. In the routine care group, receive only standard verbal instructions on Kegel exercises during regular antenatal check-ups, without app supervision. Undergo outcome evaluations at enrolment, before delivery, and at the postpartum follow-up visit, including assessments of urinary incontinence, pelvic organ prolapse, exercise adherence, self-efficacy, anxiety, and any adverse events.

Inclusion Criteria: * Age ≥ 19 years * Singleton pregnancy with cephalic presentation； * No absolute contraindications to vaginal delivery； * No history of urinary incontinence, pelvic organ prolapse, or pelvic floor surgery before pregnancy； * Ability and willingness to comply with the full prenatal and postpartum follow-up schedule； * Signed written informed consent. Exclusion Criteria: * History of second- or third-trimester miscarriage, recurrent miscarriage, or spontaneous preterm birth； * Presence of pregnancy complications, such as severe preeclampsia, fetal distress, placenta previa, placental abruption, or symptoms of threatened preterm labour； * Contraindications to exercise, including cervical shortening, cervical insufficiency, or unexplained vaginal bleeding or fluid leakage； * Comorbid conditions, such as asthma, cardiovascular disease, hypertension, uncontrolled diabetes mellitus, or thyroid disease； * Metabolic bone disease or limited joint mobility； * Cognitive or psychiatric disorders that prevent the participant from completing diary records； * Concurrent participation in another pelvic floor intervention study.