Combined electrical muscle stimulation and proprioceptive training for pelvic floor dysfunction: a retrospective cohort study

Abstract

Background: Pelvic floor dysfunction (PFD) commonly affects postpartum women, yet surgical interventions carry invasiveness and recurrence risks. This retrospective study aims to investigate the effects of pelvic floor electrical muscle stimulation (EMS) combined with proprioceptive training (PT) on pelvic floor function and structural integrity in women with PFD. Methods: A total of 320 women with PFD treated at Ningde Municipal Hospital from October 2022 to December 2024 were stratified into control group, EMS group, PT group and combined group, with 80 patients in each group. All patients received routine pelvic floor functional training; the EMS group additionally received pelvic floor EMS, the PT group received PT and the combined group received pelvic floor EMS following PT. Pelvic floor resting/tonic contraction electromyography (EMG) value, muscle fibre strength, pelvic floor distress inventory-short form 20 (PFDI-20) scores, and pelvic floor ultrasound parameters were assessed before and after treatment. Results: Post-treatment, all groups showed significant improvements in resting/tonic contraction EMG value, muscle fibre strength, PFDI-20 scores and pelvic floor ultrasound parameters (levator ani muscle (LAM) thickness, bladder neck descent, etc.) compared to baseline (p < 0.001). The combined group achieved superior outcomes across all measures (p < 0.0001), with higher EMG value, greater structural restoration (e.g. increased LAM thickness, reduced hiatus area). No baseline differences were observed among groups (p > 0.05), confirming treatment-specific efficacy of the combined approach. Conclusions: Pelvic floor EMS combined with PT effectively promotes recovery of pelvic floor function and structural integrity in women with PFD. This combined therapy warrants clinical application and dissemination.