Biomechanics-Driven Rehabilitation for Pelvic Floor Dysfunction: Efficacy and Predictors of Combined Biofeedback Electrical Stimulation and Hip Muscle Training in Postpartum Stress Urinary Incontinence.

内容摘要

This study aimed to evaluate the therapeutic efficacy of hip muscle training combined with pelvic floor biofeedback electrical stimulation (BES) in postpartum patients with stress urinary incontinence (SUI) and identify predictors of treatment outcomes. A total of 142 SUI patients were randomly allocated to a control group (n = 71, pelvic floor muscle training [PFMT] + BES) or an observation group (n = 71, PFMT + BES + hip muscle training). Outcomes included therapeutic efficacy, pelvic floor muscle strength (GRRUG criteria), and incontinence symptoms (International Consultation on Incontinence Questionnaire-Short Form [ICI-Q-SF]). Univariate and multivariate logistic regression analyses were performed to identify predictors of treatment success. The observation group exhibited a significantly higher total efficacy rate (94.4% vs. 74.6%, p = 0.001) and a greater proportion of grade III or higher pelvic floor muscle strength (88.7% vs. 70.4%, p = 0.007). Post-intervention, the observation group demonstrated superior improvements in leakage frequency, urine volume, and quality of life impact (all p < 0.001). Univariate analysis identified parity, delivery mode, gestational weight gain, fetal weight, episiotomy, bladder neck mobility, SUI severity, and intervention type as significant predictors (p < 0.05). Multivariate analysis confirmed gestational weight gain <17.5 kg, absence of episiotomy, reduced bladder neck mobility, mild SUI, and combined therapy as independent protective factors (all p < 0.05). The integration of hip muscle training with pelvic floor BES significantly improves SUI symptoms and pelvic floor function. This biomechanically synergistic approach provides a novel framework for personalized postpartum rehabilitation.