Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jun 19, 2025; 15(6): 103738
Published online Jun 19, 2025. doi: 10.5498/wjp.v15.i6.103738
Individualized pelvic floor rehabilitation training on psychological and functional recovery in postpartum women with generalized anxiety disorder
Cong-Ying Zhao, Shu-Qing Han, Xian-Chai Peng, Zhen-Hong Liu
Cong-Ying Zhao, Department of Ultrasound Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang 050005, Hebei Province, China
Shu-Qing Han, Department of Plastic Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050005, Hebei Province, China
Xian-Chai Peng, Department of Obstetrics, The Second Hospital of Hebei Medical University, Shijiazhuang 050005, Hebei Province, China
Zhen-Hong Liu, Department of Psychiatry, The Second Hospital of Hebei Medical University, Shijiazhuang 050005, Hebei Province, China
Author contributions: Zhao CY and Liu ZH conceived this project; Han SQ collected and analyzed the data; Zhao CY and Liu ZH jointly wrote the initial draft of the manuscript; Peng XC provided expert advice and revised the manuscript. All the authors contributed to this study and approved the submitted version.
Supported by 2022 Annual Medical Science Research Project Plan of Hebei Province, No. 20221111.
Institutional review board statement: The study has been reviewed and approved by the Ethics Committee of the Second Hospital of Hebei Medical University.
Informed consent statement: Written informed consent was obtained from all the subjects.
Conflict-of-interest statement: We declare no conflict of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cong-Ying Zhao, MD, Department of Ultrasound Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Xinhua District, Shijiazhuang 050005, Hebei Province, China. congyingzcy@163.com
Received: March 7, 2025
Revised: April 8, 2025
Accepted: April 23, 2025
Published online: June 19, 2025
Processing time: 83 Days and 1.6 Hours
Abstract
BACKGROUND

Postpartum women are at an increased risk of generalized anxiety disorder (GAD), which can negatively affect both mental health and physical recovery. Pelvic floor dysfunction, common in this population, can exacerbate psychological distress. Although pelvic floor rehabilitation is effective in physical recovery, its potential to improve psychological outcomes, especially in women with GAD, remains underexplored.

AIM

To evaluate the effectiveness of an individualized pelvic floor rehabilitation program in improving anxiety, pelvic floor function, and quality of life in postpartum women with GAD.

METHODS

A retrospective study was performed to analyze 80 postpartum women with GAD who completed a 12-week individualized pelvic floor rehabilitation program (January 2020-December 2024), combining supervised pelvic floor muscle training and psychological support. Primary outcomes were changes in GAD-7 and Hamilton anxiety rating scale (HAM-A) scores and pelvic floor function measured by surface electromyography (sEMG). Secondary outcomes included World Health Organization quality of life-BREF, pelvic floor symptom severity, and impact on daily activities (pelvic floor impact questionnaire). Assessments were conducted at baseline and 6 and 12 weeks during the intervention period.

RESULTS

Significant improvements were observed in anxiety measures, with mean GAD-7 scores decreasing from 14.8 ± 3.2 at baseline to 8.2 ± 2.9 at week 12 (P < 0.001) and HAM-A scores decreasing from 22.6 ± 4.5 to 12.4 ± 3.8 (P < 0.001). Pelvic floor function showed substantial enhancement, with sEMG amplitude increasing from 22.4 ± 5.6 µV to 35.9 ± 6.8 µV (P < 0.001). Quality of life improved across all domains, with the most significant improvements in psychological (28.5% increase) and physical health (25.8% increase). Program adherence was 91.5% for the supervised sessions, and no serious adverse events were reported.

CONCLUSION

Individualized pelvic floor rehabilitation training effectively improves both psychological and functional outcomes in postpartum women with GAD. The high adherence and significant outcomes make this integrated approach feasible and effective.

Keywords: Generalized anxiety disorder; Pelvic floor rehabilitation; Postpartum care; Physical therapy; Mental health

Core Tip: Individualized pelvic floor rehabilitation combining muscle training and psychological support improved anxiety symptoms significantly and pelvic floor function in postpartum women with generalized anxiety disorders (GAD). This integrated approach led to notable gains in mental health, physical recovery, and quality of life, with high program adherence and no serious adverse events. These findings suggest that a combination of physical and psychological interventions offers a comprehensive and effective treatment option for postpartum GAD.