Effect of Time Choice of Pastpartum Pelvic Floor Rehabilitation on Urinaty Incontinence and Pelvic Floor Muscles

Objective Through follow- up and controlling studies of pelvic floor rehabilitation training for the puerperas who accepted electrical stimulation in combination with biofeedback training in different time,to evaluate the effects of practicing pelvic floor rehabilitation in different postpartum periods on urinary incontinence and pelvic floor muscles,so as to provide a basis for prevention of disease and choice of the best time of rehabilitation training. Methods From August 2010 to July2011,totally 88 puerperas who practiced postpartum pelvic floor rehabilitation in Peking University Shenzhen Hospital were enrolled as the training group,then according to the starting time of training after delivery,they were divided into four groups: 25as Group A( postpartum 6 weeks t≤8 weeks),41 as Group B( postpartum 8 weeks t≤10 weeks),and 22 as Group C( postpartum 10 weeks t≤13 weeks). The concurrent 60 puerperas 6-8 weeks after delivery were selected as control group,who only received postpartum health instruction. At the end of the training for the trial groups and 6 months after delivery for the control group,the general conditions,urinary incontinence symptom and the improvement of pelvic floor muscle strength were assessed with questionnaire survey. Results( 1) There were no significant difference in positivity rate of urinary incontinence,the type Ⅰ and Ⅱ muscle strength among different periods in the control group( P 0. 05).( 2) Before the training there were no significant differences between the training group and the control group in positivity rate of urinary incontinence,the type Ⅰand Ⅱ muscle strength( P 0. 05). But 6 months after the training,in the training group,the possibility rate of urinary incontinence decreased,and the type Ⅰ and Ⅱ muscle strength increased( P 0. 05).( 3) At the end of training and 6 months after delivery,in the training group,the positivity rate of urinary incontinence decreased,and the type Ⅰ and Ⅱ muscle strength increased,with significant differences as compared with before training( P 0. 05). At the end of training and 6 months after delivery,there were no significant difference in positivity rate of urinary incontinence,the type Ⅰ amd Ⅱ muscle strength among A,B and groups( P 0. 05). No side effects were found in all the puerperas in any group. Conclusion( 1) The functional recovery ability of maternal pelvic floor muscle by herself is limited,and it is difficult for the injured pelvic floor muscle to recover naturally.( 2) The electrical stimulation in combination with biofeedback training could effectually lower the positivity rate of urinary incontinence,and enhance the pelvic floor muscle strength.( 3) The rehabilitation training starting at the different time periods could all reduce the positivity rate of urinary incontinence,and raise the pelvic floor muscle strength. No significant difference was found in different times to start training.