Individualized pelvic floor rehabilitation training on psychological and functional recovery in postpartum women with generalized anxiety disorder

Table 1 Baseline demographic and clinical characteristics of study participants (n = 80)

Characteristic	Value
Age (years)
mean ± SD	31.4 ± 4.8
Range	22-42
BMI (kg/m²)
mean ± SD	24.6 ± 3.2
Range	19.2-31.5
Time since delivery (months)
Median (IQR)	4.2 (2.8-6.5)
Range	1.5-11.0
Mode of delivery, n (%)
Vaginal delivery	52 (65.0)
Spontaneous	38 (47.5)
Instrumental	14 (17.5)
Cesarean section	28 (35.0)
Elective	16 (20.0)
Emergency	12 (15.0)
Parity, n (%)
Primiparous	46 (57.5)
Multiparous	34 (42.5)
Educational level, n (%)
Secondary education	18 (22.5)
Tertiary education	62 (77.5)
Employment status, n (%)
Employed	58 (72.5)
Unemployed	22 (27.5)
Marital status, n (%)
Married/partnered	75 (93.8)
Single/separated	5 (6.2)
Baseline anxiety measures
GAD-7 score, mean ± SD	14.8 ± 3.2
HAM-A score, mean ± SD	22.6 ± 4.5
Baseline pelvic floor assessment
Modified Oxford Scale score, median (IQR)	2 (2-3)
sEMG amplitude (µV), mean ± SD	22.4 ± 5.6
PFDI-20 score, mean ± SD	85.4 ± 22.3
Concurrent treatments, n (%)
Psychological counseling	32 (40.0)
Anxiolytic medication	18 (22.5)
Previous pelvic floor therapy	12 (15.0)

PFDI-20: Pelvic floor distress inventory; GAD-7: Generalized anxiety disorder-7 scale; BMI: Body mass index; HAM-A: Hamilton anxiety rating scale.

Table 2 Changes in physical and psychological outcomes over the 12-week intervention period

Outcome measure	Baseline	Week 6	Week 12	Mean change (95%CI)	P value
Anxiety measures
GAD-7 score	14.8 ± 3.2	11.3 ± 3.0	8.2 ± 2.9	-6.6 (-7.2 to -6.0)	< 0.001
HAM-A score	22.6 ± 4.5	17.2 ± 4.1	12.4 ± 3.8	-10.2 (-11.1 to -9.3)	< 0.001
Pelvic floor function
sEMG amplitude (µV)	22.4 ± 5.6	28.7 ± 6.2	35.9 ± 6.8	13.5 (12.2 to 14.8)	< 0.001
Contraction duration (s)	4.2 ± 1.8	6.8 ± 2.1	8.9 ± 2.3	4.7 (4.2 to 5.2)	< 0.001
Modified Oxford Scale score1	2 (2-3)	3 (3-4)	4 (3-4)	-	< 0.001
Clinical assessments
PFDI-20 score	85.4 ± 22.3	62.8 ± 20.1	42.6 ± 18.4	-42.8 (-47.3 to -38.3)	< 0.001
PFIQ-7 score	68.9 ± 19.8	48.5 ± 17.2	32.4 ± 15.6	-36.5 (-40.4 to -32.6)	< 0.001
Quality of life (WHOQOL-BREF)
Physical health	45.2 ± 8.4	58.6 ± 9.2	71.0 ± 10.1	25.8 (23.5 to 28.1)	< 0.001
Psychological health	42.8 ± 7.9	57.2 ± 8.8	71.3 ± 9.8	28.5 (26.2 to 30.8)	< 0.001
Social relationships	48.5 ± 9.1	58.9 ± 9.5	67.2 ± 10.2	18.7 (16.4 to 21.0)	< 0.001
Environmental	52.3 ± 8.8	60.1 ± 9.3	67.7 ± 9.9	15.4 (13.1 to 17.7)	< 0.001

¹Modified Oxford Scale score presented as median (IQR).

Other values are presented as the mean ± SD. GAD-7: Generalized anxiety disorder-7 scale; HAM-A: Hamilton anxiety rating scale; PFDI-20: Pelvic floor distress inventory; PFIQ-7: Pelvic floor impact questionnaire; WHOQOL-BREF: World Health Organization quality of life-BREF questionnaire; sEMG: Surface electromyography.