Zhongguo quanke yixue (Feb 2024)
Biofeedback Electrical Stimulation Therapy in the Rehabilitation of Pelvic Floor Function after Vaginal Delivery: a Clinical Randomized Controlled Study
Abstract
Background Pregnancy and vaginal delivery are important factors leading to pelvic floor dysfunction (PFD) in women, manifested as pelvic organ prolapse (POP), stress urinary incontinence (SUI), and sexual dysfunction. Postpartum pelvic floor function rehabilitation has become a research hotspot in recent years. Stimulating the pelvic floor muscle groups through active exercise and passive contraction can improve detrusor stability and levator muscle function to prevent and treat PFD. Objective To investigate the clinical value of biofeedback electrical stimulation combined with pelvic floor muscle training (PFMT) therapy in the rehabilitation of pelvic floor function after vaginal delivery through a clinical controlled study. Methods Postpartum women with PFD after delivery implemented in Department of Obstetrics and Gynecology, Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2020 to January 2022 were selected as the research subjects, and divided into the observation group and the control group using a random number table method. The observation group was treated with biofeedback electrical stimulation combined with PFMT, while the control group was treated with PFMT alone. The muscle strength of the pelvic floor class Ⅰ and class Ⅱ muscle fibers, the ratio of SUI and POP level of the two groups before and after treatment; postpartum PFMT situation; scores of Pelvic Floor Dysfunction Questionnaire (PFDI-20), Pelvic Floor Impact Questionnaire-7 (PFIQ-7), and International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICI-Q-SF) before and at 3 and 6 months after the treatment. Results A total of 327 cases were included in the observation group and 343 cases in the control group. After the treatment, the strength recovery of type Ⅰ and Ⅱ muscle fibers in the observation group was better than the control group (P<0.001). The ratio of SUI in the observation group was lower than that in the control group (P=0.005). There was no significant difference in POP level between the two groups (P>0.05). The proportion of PFMT frequency≥5 times/week in the observation group was higher than that in the control group at 3 months and 6 months after treatment (P<0.001) ; the PFDI-20, PFIQ-7, and ICI-Q-SF scores of the observation group were lower than those of the control group at 3 months and 6 months after treatment (P<0.05) . Conclusion Compared with PFMT alone, the patients of vaginal delivery with the treatment of biofeedback electrical stimulation combined with PFMT had better muscle strength recovery, lower SUI ratio, higher compliance with PFMT, and better quality of life score.
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