Construction of a postpartum pelvic floor rehabilitation exercise programme based on the Delphi method

Abstract

Background Pelvic floor dysfunction (PFD) affects women’s health and quality of life seriously. Postpartum is a crucial stage and ideal opportunity for the prevention and treatment of PFD diseases. Therefore, it is essential to promote postpartum physical recovery and effectively improve the prevention and treatment effect of PFD through a simple, non-invasive and high-compliance pelvic floor rehabilitation programme during postpartum pelvic floor rehabilitation.Methods A literature review was conducted to develop the initial list of competencies which consisted of 23 items from six models. Two rounds of Delphi Surveys were conducted, inviting experts via email to rate the importance of each item and provide qualitative comments on their ratings. Consensus was predefined as a mean score of 4.0 or above and at least 75% agreement among the participants.Results The postnatal pelvic floor rehabilitation exercise programme developed in this study was guided by the ‘holistic pelvic floor theory’ proposed by Petros and Ulmsten. The effective recovery rate of the two rounds of expert consultation questionnaires was 100%. In the first round, some items were changed according to experts’ opinions. In the second round, the expert authority coefficient was 0.819. The Kendall coefficient of expert opinion was 0.154 (p<0.01). The final plan included 6 modules with 23 items. The postpartum pelvic floor rehabilitation exercise programme was formed, consisting of six exercises (APBKQS-exercise) such as abdominal breathing, pelvic exercise, bridge exercise, kneeling balance, quadrupedal stretching and supine hand-and-knee confrontation.Conclusion The postnatal pelvic floor rehabilitation exercise programme constructed in this study integrates multiple exercises (APBKQS-exercise). Theexercise programme guided by the ‘holistic pelvic floor theory’ incorporates the use of Women's Active Functional Fitness Equipment (WAFF) exercise air cushions to better achieve the purpose of alleviating joint pain, loosening contracture muscles, repairing pelvic floor muscles, strengthening abdominal core strength, and recovering body shape as soon as possible.