Comparable efficacy of biofeedback electrical stimulation on postpartum pelvic floor dysfunction stratified by baseline muscle strength: retrospective cohort study

Background To evaluate the therapeutic effects of biofeedback electrical stimulation on pelvic floor muscle function in postpartum women with varying baseline muscle strength, stratified by the modified oxford scale. Methods This retrospective cohort study included postpartum women diagnosed with pelvic floor dysfunction who received treatment at Fujian Maternity and Child Health Hospital between January 2024 and March 2025. Participants within 6 months postpartum were eligible if they had pelvic organ prolapse or stress urinary incontinence. Women were stratified into low-strength(MOS 0–2)and moderate-strength༈MOS 2–4༉groups. All participants completed 15 sessions of standardized biofeedback electrical stimulation over two months. Outcomes were assessed at baseline and post-treatment, including modified oxford scale, pelvic organ support using the pelvic organ prolapse quantification system, and surface electromyography parameters based on the Glazer protocol. Between-group and within-group changes were analyzed using appropriate parametric or nonparametric tests. Results A total of 126 participants met the sample size requirements and exhibited comparable baseline demographic and obstetric characteristics. Both groups showed significant improvements following biofeedback electrical stimulation. Modified oxford scale scores improved markedly in the low-strength and moderate-strength groups. pelvic organ prolapse quantification points Aa, Ba, and C demonstrated significant improvement without deterioration of other anatomical points. All surface electromyography parameters across the five Glazer protocol phases improved significantly within each group, with moderate to large effect sizes. However, no significant between-group differences were observed in changes across above outcomes, indicating comparable treatment response regardless of baseline muscle strength. Conclusion A 15-session course of biofeedback electrical stimulatio significantly enhances pelvic floor muscle strength, neuromuscular activation, and selective pelvic organ support in postpartum women. The magnitude of therapeutic benefit was similar between low-strength and moderate-strength groups, suggesting that biofeedback electrical stimulatio is broadly effective across varying levels of initial pelvic floor dysfunction. These findings support the use of biofeedback electrical stimulatio as a widely applicable postpartum rehabilitation strategy and highlight the value of individualized assessment.