Efficacy of correction of pelvic floor muscle dysfunction using physical therapy in women who underwent Caesarean section

Abstract

Problem Statement. The increase in the number of women giving birth by Caesarean section, is actualizing the development and implementation of physical therapy to restore their health and improve their quality of life. Approach: determination of the influence of the developed program of physical therapy on the dynamics of signs of pelvic floor muscle dysfunction in women in the postpartum period after Caesarean section. Methods: There were examined 112 postpartum women. Comparison group consisted of 47 women who gave birth naturally. Main group 1 consisted of 32 post-Caesarean section women who recovered on their own. Main group 2 consisted of 33 women after Caesarean section who had postpartum physical therapy for 12 months (kinesitherapy, functional training, abdominal bandage, kinesio taping, abdominal and general massage; healthy nutrition, psychological relaxation, education of women). Determination of pelvic floor muscle dysfunction (tone mm. levator ani (using palpation), strength (with perineometry), signs of weakness and their severity (Pelvic Floor Distress Inventory (PFDI-20)), impact on daily activity, social and emotional spheres (Pelvic Floor Impact Questionnaire (PFIQ-7)), changes in sexual function (Female Sexual function (FSFI-19)), was performed after 8 weeks, 6 and 12 months after childbirth. Results: In the postpartum period, pelvic floor muscle dysfunction in women manifests itself in the form of a decrease in their tone (on the results of palpation), strength (according to the data of perineometry), the presence of a pathological signs of their weakness (diagnosed according to PFDI-20), negative impact on daily activity, social and emotional spheres (defined by PFIQ-7), deterioration of sexual satisfaction (according to FSFI-19). The use of physical therapy allowed statistically significantly improve the results of all studied parameters for women in 6 months after Caesarean section (p<0.05), in comparison with women who gave birth naturally; according to the results of determining the tone mm. levator ani, PFDI-20, PFIQ-7, FSFI-19 – with those who recovered after Caesarean section independently. Performance of physical therapy with the use of exercises to correct pelvic floor muscle dysfunction one year after childbirth allowed to achieve a statistically significant improvement in the condition of main group 2 women according to all studied indices regarding the representatives of main group 1 and comparison group. Conclusions: Physical therapy means should be prescribed from the first days of postpartum rehabilitation for women giving birth by Caesarean section to reduce the intensity of signs of pelvic floor dysfunction.