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Comparative Effects of Biofeedback Electrical Stimulation, Kegel Exercise, and Vaginal Cone Training on Postpartum Pelvic Floor Muscle Weakness in Primiparous Women: A prospective real-world observational study

Wang C, Bian Z, Shao C, Ye G. · Research Square · 2026

This large observational study followed 2,403 first-time mothers who had vaginal deliveries and had weakened pelvic floor muscles at 6 weeks postpartum, comparing no treatment, Kegel exercises, vaginal cone training, and biofeedback electrical stimulation over a 6-week intervention. Muscle strength (Type I and Type II fibers) was rated at baseline, 3 months, and 9 months postpartum, and the groups differed significantly in strength distribution at both follow-ups, though the abstract is cut off before reporting which method worked best.
Takeaway: Consider starting a structured pelvic floor rehab program after childbirth rather than leaving weakness untreated.
Abstract (source)

Abstract

Purpose: To compare the effects of Kegel exercise (KE), vaginal cone (VC) training, and biofeedback electrical stimulation (BES) on pelvic floor muscle recovery in primiparous women with decreased pelvic floor muscle strength after vaginal delivery. Patients and

Methods: This prospective real-world observational study was conducted at the First Affiliated Hospital of Bengbu Medical University. A total of 2,700 eligible women with decreased pelvic floor muscle strength at 6 weeks postpartum were grouped according to the postpartum pelvic floor rehabilitation treatment they received into the untreated (UT) group, Kegel exercise (KE) group, vaginal cone (VC) group, and bioelectrical stimulation (BES) group. Interventions were administered for 6 weeks. Type I and Type II pelvic floor muscle strength grades were assessed at baseline, 3 months, and 9 months postpartum. Longitudinal changes were analyzed using cumulative link mixed models (CLMMs).

Results: A total of 2,403 participants completed follow-up and were included in the final analysis (UT, n = 608; KE, n = 600; VC, n = 599; BES, n = 596). Baseline characteristics were generally comparable across the four groups. Significant differences in the distributions of Type I and Type II pelvic floor muscle strength grades were observed at both follow-up assessments (all P

Observational / cohortRecovery & Sleep
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