International Journal of Clinical Case Reports, 2025, Vol.15, No.2, 52-58 http://medscipublisher.com/index.php/ijccr 55 In the first layer, independent variables included age, pregnancy weight gain, neonatal birth weight, and perineal wound condition. To specifically examine the impact of compliance with pelvic floor electrical stimulation combined with biofeedback therapy, compliance was included as a second-layer independent variable in the regression model. The results showed that pregnancy weight gain and compliance were ultimately included in the regression model as significant influencing factors. After adding compliance as an independent variable, the adjusted R² value of the model increased from 0.099 to 0.193, indicating that the newly added variable (compliance) explained an additional 9.4% of the variance in the dependent variable. The results are presented in Table 1. Table 1 Impact of compliance with electrical stimulation and biofeedback therapy on pelvic floor electrophysiology (n=184) Variable Unstandardized coefficient (B) Standard error Standardized coefficient (β) t-value P-value First Layer Constant 57.121 12.879 - 4.435 0.000 Age 0.169 0.266 0.046 0.636 0.526 Pregnancy Weight Gain 3.984 0.870 0.328 4.578 0.000 Perineal Condition 0.213 1.186 0.014 0.180 0.857 Neonatal Birth Weight -3.030 3.426 -0.071 -0.884 0.378 Second Layer 2) Constant 63.042 12.249 - 5.147 0.000 Age 0.229 0.252 0.062 0.908 0.365 Pregnancy Weight Gain 3.412 0.832 0.281 4.099 0.000 Perineal Condition -0.388 1.129 -0.026 -0.344 0.732 Neonatal Birth Weight 0.480 3.327 0.011 0.144 0.885 Compliance -1.467 0.313 -0.326 -4.690 0.000 Note: First Layer Adjusted R2=0.099, F=6.020, P=0.000; Second Layer Adjusted R2=0.193, F=9.779, P=0.000 4 Discussion 4.1 Poor compliance with pelvic floor electrical stimulation combined with biofeedback therapy The study results showed that the compliance score for pelvic floor electrical stimulation combined with biofeedback therapy ranged from 0 to 5, with a mean score of 2.37 ± 1.377. Only 19 patients (10.3%) fully adhered to the prescribed therapy, indicating poor compliance, which is consistent with previous studies (Zheng, 2023). Possible reasons for this include discomfort during treatment. Electrical stimulation may cause sensations such as soreness and tingling in the pelvic floor muscles, which some patients find intolerable for extended periods, reducing their willingness to continue treatment. Additionally, this therapy requires patients to visit the hospital or rehabilitation center regularly, which may be difficult for those with demanding work schedules or heavy family responsibilities. Another possible reason for poor compliance is a lack of awareness regarding pelvic floor electrophysiological abnormalities (Wu et al., 2019; Sawettikamporn et al., 2022). Some patients may believe that rest and simple self-exercises are sufficient for recovery, neglecting professional treatment and further reducing compliance. The recovery of pelvic floor muscle function requires consistent stimulation and training, and incomplete treatment may lead to inadequate muscle strength improvement and poor muscle coordination. Consequently, symptoms associated with pelvic floor dysfunction, such as urinary incontinence and pelvic organ prolapse, may progress, increasing the complexity and cost of subsequent treatments. To address this issue, it is essential to enhance patient education on pelvic floor electrophysiological abnormalities. Additionally, personalized adjustments to electrical stimulation parameters (e.g., current intensity, frequency, and pulse width) should be made based on individual differences such as pelvic floor electrophysiological status and pain tolerance. This approach can ensure treatment efficacy while reducing discomfort and improving patient tolerance. Furthermore, treatment schedules should be adapted to patients' work and lifestyle commitments. Strategies such as extending treatment hours (e.g., adding morning and evening sessions), offering
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