Effectiveness of telehealth pelvic-abdominal mechanics training rehabilitation program for pelvic floor rehabilitation in puerperal women: a randomized controlled study.

Abstract

Background: There are still numerous barriers to the implementation of pelvic floor muscle training (PFMT), though it has been the first-line treatment for pelvic floor dysfunction (PFD) in puerperal women. The construction of telehealth pelvic floor rehabilitation program that is both fun and accessible is necessary.

Aim: To assess the efficacy of telehealth pelvic-abdominal mechanics rehabilitation training program for pelvic floor rehabilitation in puerperal women.

Design: A randomized controlled trial.

Setting: Home-based exercise program.

Population: Singleton, cephalic primiparous women.

Methods: The 60 participants recruited were randomly assigned to either the intervention or control group. The intervention group received a telehealth pelvic-abdominal mechanics training rehabilitation program for 6 weeks, while the control group remained on the routine care. The degree of distress of PFD in puerperal women was assessed at one week postpartum (T1) and 42 days postpartum (T2). The level of knowledge, attitudes and self-efficacy towards PFMT were assessed at 2 days postpartum (T0), T1and T2. The degree of inter-recti distance (IRD) was assessed at T0 and T2. Pelvic floor muscle strength was assessed at T2, including modified Oxford muscle strength (MOS) classification and dynamic maximal vaginal pressure values. Statistical analysis methods were chosen based on the type of statistical data, mainly including t-test and two-factor repeated measures ANOVA.

Results: No adverse outcomes occurred in all participants. After a 6-week intervention, the intervention group had a significantly lower PFDI-20 score than the control group at T2 and exhibited a lesser degree of IRD. At T1 and T2, the simple effect of group was significant, with the intervention group demonstrating higher levels of knowledge and attitude towards PFMT compared to the control group (F=4.427, P=0.040, partial η²=0.071; F=5.266, P=0.025, partial η²=0.083). At T2, the simple effect of group was significant, with the intervention group demonstrating higher level of self-efficacy towards PFMT compared to the control group (F=37.908, P<0.001, partial η²=0.395). There was no statistically significant difference between the two groups in terms of Oxford muscle strength classification, dynamic maximal vaginal pressure values, muscle fiber strength of type I and type II at T2.

Conclusions: This study provided evidence that telehealth pelvic-abdominal mechanics training rehabilitation program can significantly improve the rehabilitation effect of puerperal women.

Clinical rehabilitation impact: A pelvic-abdominal mechanics training rehabilitation program during the puerperium is safe and effective. Telemedicine is an extremely recommended means of pelvic floor rehabilitation during the puerperium.