International Journal of Clinical Case Reports, 2025, Vol.15, No.2, 52-58 http://medscipublisher.com/index.php/ijccr 53 have specifically examined patient compliance with pelvic floor electrical stimulation combined with biofeedback therapy or its impact on pelvic floor electrophysiology. Therefore, this study employs a retrospective cohort design to investigate patient compliance with this therapy and its effects on pelvic floor electrophysiology. 2 Subjects and Methods 2.1 Study Subjects Patients who visited the Pelvic Floor Rehabilitation Center of a tertiary hospital in Beijing between January 2024 and December 2024 were included in this study. The inclusion criteria were as follows: (1) primiparous women who had undergone natural delivery; (2) full-term singleton pregnancy; (3) age >20 years; (4) within 6 weeks to 6 months postpartum; (5) complete postpartum lochia discharge; and (6) informed consent and voluntary participation in the study. The exclusion criteria included: (1) postpartum hemorrhage; (2) chronic conditions causing sustained intra-abdominal pressure increases, such as chronic cough or constipation; (3) a history of pelvic surgery; and (4) vaginal bleeding. A retrospective analysis was conducted on the basic and clinical information of patients who met the inclusion and exclusion criteria. Initially, 213 primiparous women with natural delivery were identified, and after excluding those with missing data, a total of 184 patients were included in the final analysis. In terms of quality control, training of collection personnel, implementation of two-person check, integrity check, at least 10% of the data every week. When reviewing the records, the records of patients undergoing pelvic floor rehabilitation therapy in the system were first comprehensively searched, and then screened according to the inclusion and exclusion criteria, and the records of serious information missing, non-diagnosis and treatment in our hospital and participation in other clinical trials were excluded to ensure the accuracy and integrity of the data.This study has been approved by the Ethics Committee of Xuanwu Hospital, Capital Medical University (No. [2023] 055). 2.2 Assessment tools 2.2.1 Compliance assessment scale for pelvic floor electrical stimulation combined with biofeedback therapy Based on the definition of compliance proposed by the World Health Organization (WHO) (Burkhart and Sabaté, 2003) and previous research on pelvic floor muscle therapy (Wang and Wu, 2023), this study defined compliance with pelvic floor electrical stimulation combined with biofeedback therapy as the degree to which the frequency, sessions, and execution quality of the therapy aligned with the treatment plan jointly established by the healthcare provider and the patient. Accordingly, a compliance assessment scale for pelvic floor electrical stimulation combined with biofeedback therapy was developed and evaluated by responsible nurses based on patients' actual performance. The scale included the following criteria: Treatment sessions completed according to the agreed plan (fully completed=1 point, not completed=0 points). Treatment frequency according to the agreed plan (fully completed=1 point, not completed=0 points). Execution quality of movements, assessed based on abdominal muscle involvement (<10% involvement=2 points, 10%~30% involvement=1 point, 30% involvement=0 points). Adherence to treatment duration (typically 30 minutes; completed=1 point, not completed=0 points). The total score ranged from 0 to 5, with higher scores indicating better compliance with pelvic floor electrical stimulation combined with biofeedback therapy. To ensure the scientific validity, practicality, and effectiveness of the scale, six experts experienced in pelvic floor rehabilitation reviewed its content completeness, item rationality, scoring criteria, and clinical applicability using a four-point Likert scale (1=completely irrelevant, 5=highly relevant). The average score for all items was 3.833, indicating high content validity. 1.2.2 Pelvic floor electrophysiology assessment scores Before the onset of symptomatic PFD, the primary manifestation of pelvic floor dysfunction is abnormal electromyographic (EMG) signals. Surface electromyography (sEMG) is a widely used clinical method for assessing pelvic floor muscle function, evaluating muscle strength, tone, activation speed, and coordination under
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