The Evaluation Of Therapy Effect On Postpartum Pelvic Floor Rehabilitation

Objective:To investigate the effect of biofeedback,electrical stimulationcombined pelvic floor muscle training on postpartum pelvic floorrehabilitation.Methods:A total of609post-partum women6weeks after delivery were recruitedfrom the Maternal and Child Health Hospital of Jiangxi Province, amongwhom the pelvic floor muscle strength between levels II to IV evaluatedby GRRUG were included in this study. These individuals were randomlydivided into eight groups: exercise group (A group), electricalstimulation group (B group), biofeedback group (C group), exercise pluselectrical stimulation group (AB group), exercise plus biofeedback group(AC group), electrical stimulation plus biofeedback group (BC group),exercise plus electrical stimulation plus biofeedback group (ABC group)and control group (D group). The control group was untreated and onlyfollowed general guidance postpartum recovery. The InternationalConsultation on Incontinence Questionnaire-Short Form (ICI-Q-SF), theFemale Sexual Function Inventory (FSFI) questionnaire, the mean valueof pelvic muscle electromyography (EMG), fatigue and Pelvic OrganProlepses Quantization (POP-Q) were used to assess the effects of therapyto the post-partum women at6weeks and6months.Results:EMG and fatigue differences were not statistically significant amongthe8groups prior to the treatment (P>0.05), there were statisticallysignificant differences in each group after their treatments (P<0.05),Factorial analysis of variance analyzed the interactions between thethree different factors, i.e., exercise, electrical stimulation,biofeedback, and found that their main effects presented with statistically significant differences (P<0.01); there were synergisticeffects in improving the mean value of EMG and lowering fatigability whentaking advantage of exercise joint electrical stimulation andbiofeedback (P <0.01), there were synergistic effects in loweringfatigability when taking advantage of three combined treatment.All of the POP-Q points were less than degree II, before theirtreatments in each group and no significant differences were observedamong the8groups(P>0.05) There were significant differences in eachgroup after their treatments(P<0.05), three combined group showedsignificant difference when compared with the control group (P<0.0042,P′<0.0042concerned statistically significant difference), while theremaining treated group showed no significant difference when comparedwith control group (P>0.0042); moreover, the Pair wise comparisons amongall of the treated groups presented no statistical difference (P>0.0024,P′<0.0024concerned statistically significant difference).The incidence of stress urinary incontinence (SUI) in each group hadno significant difference before treatment (P>0.05). After theirtreatments, all of the three groups of exercise plus electricalstimulation, electrical stimulation plus biofeedback, three combinedgroup(P<0.0042), but not the remaining groups (P>0.0024), showedstatistically significant differences when compared with the controlgroup after treatment; and there was no significant difference amongtreated groups.Before the treatment, the proportion of sexual quality with high levelamong all of these groups was zero and there was no statisticallysignificant difference among these groups (P>0.05). While after thetreatment, there were statistically significant differences in thecombined groups when compared with the control group (P<0.0042); therewer statistically significant difference in three combined group whencompared with the single groups and two-combinede groups(P>0.0024). Conclusions:The single and combined rehabilitations are effective for postpartumpelvic floor rehabilitation, among which the electrical stimulationcombined with biofeedback and three-combined-way have synergisticeffects.