Zhao Cong-Ying, Han Shu-Qing, Peng Xian-Chai, Liu Zhen-Hong
Department of Ultrasound Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang 050005, Hebei Province, China.
Department of Plastic Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang 050005, Hebei Province, China.
World J Psychiatry. 2025 Jun 19;15(6):103738. doi: 10.5498/wjp.v15.i6.103738.
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 ( < 0.001) and HAM-A scores decreasing from 22.6 ± 4.5 to 12.4 ± 3.8 ( < 0.001). Pelvic floor function showed substantial enhancement, with sEMG amplitude increasing from 22.4 ± 5.6 µV to 35.9 ± 6.8 µV ( < 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.
背景：产后女性患广泛性焦虑症（GAD）的风险增加，这会对心理健康和身体恢复产生负面影响。盆底功能障碍在这一人群中很常见，会加剧心理困扰。尽管盆底康复对身体恢复有效，但其改善心理结局的潜力，尤其是对患有广泛性焦虑症的女性，仍未得到充分探索。 目的：评估个性化盆底康复计划对改善产后广泛性焦虑症女性的焦虑、盆底功能和生活质量的有效性。 方法：进行一项回顾性研究，分析80名完成了为期12周个性化盆底康复计划（2020年1月至2024年12月）的产后广泛性焦虑症女性，该计划结合了监督下的盆底肌肉训练和心理支持。主要结局是GAD-7和汉密尔顿焦虑量表（HAM-A）评分的变化，以及通过表面肌电图（sEMG）测量的盆底功能。次要结局包括世界卫生组织生活质量简表、盆底症状严重程度以及对日常活动的影响（盆底影响问卷）。在干预期间的基线、第6周和第12周进行评估。 结果：焦虑测量指标有显著改善，GAD-7平均评分从基线时的14.8±3.2降至第12周时的8.2±2.9（<0.001），HAM-A评分从22.6±4.5降至12.4±3.8（<0.001）。盆底功能有显著增强，sEMG振幅从22.4±5.6µV增加到35.9±6.8µV（<0.001）。生活质量在所有领域均有改善，心理领域改善最为显著（提高28.5%），身体健康领域（提高25.8%）。监督课程的计划依从率为91.5%，未报告严重不良事件。 结论：个性化盆底康复训练有效改善了产后广泛性焦虑症女性的心理和功能结局。高依从性和显著结局使这种综合方法可行且有效。
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