The effect of rehabilitation exercises combined with direct vagina low voltage low frequency electric stimulation on pelvic nerve electrophysiology and tissue function in primiparous women: A randomised controlled trial

J Clin Nurs. 2017 Dec;26(23-24):4537-4547. doi: 10.1111/jocn.13790. Epub 2017 May 23.


Aim and objective: To evaluate the effect of rehabilitation exercises combined with Direct Vagina Low Voltage Low Frequency Electric Stimulation (DES) on pelvic nerve electrophysiology and tissue function after delivery.

Background: Whether and how DES effects pelvic floor dysfunction (PFD) are not known clearly.

Design: This was a randomised, controlled clinical trial.

Methods: The 189 primiparous women 20-35 years old and with an episiotomy or second degree episiotomy tear were divided into three groups: the control group (n = 60) received routine postpartum guidance 2 hr postpartum, the training group (n = 63) performed rehabilitation exercises (Kegel exercises and pelvic movements) from 2 days postpartum until 3 months postpartum, and the combination group (n = 66) received DES 15 times (3 times a week for 30 min at a time) beginning at the sixth week postpartum in addition to performing rehabilitation exercises. Adopt international standard scale and score method to inspect maternal life treatment, such as pelvic organ prolapse situation (POP-Q division), the degree of incontinence score and pelvic floor muscle intensity of muscular contraction. Data were collected during the third month after delivery.

Results: Three months postpartum, there were differences among the three groups in the POP-Q grade, the degree of incontinence score, the Oxford grade for pelvic floor muscle strength and the pelvic floor muscle electrophysiology condition. Additionally, there were significant differences regarding the pubic symphysis clearance. Rehabilitation exercises can promote healing of the maternal pubic symphysis and recovery of the pelvis. The total electrical value, type I muscle fibre strength and type II muscle fibre strength were significantly increased in the combination group after treatment than before treatment.

Conclusion: Rehabilitation exercises combined with DES were beneficial to the recovery of postpartum pelvic nerve tissue function, and a synergistic effect was observed when the two methods were combined.

Relevance to clinical practice: These conclusions justify that rehabilitation exercise combined with DES can better relieve uncomfortable symptoms postpartum and improve the women's quality of life.

Keywords: direct vagina low voltage low frequency electric stimulation; neurophysiology; pelvic floor dysfunction; rehabilitation exercises.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Case-Control Studies
  • Delivery, Obstetric / rehabilitation*
  • Electric Stimulation Therapy / methods*
  • Episiotomy / adverse effects
  • Exercise Therapy / instrumentation*
  • Female
  • Humans
  • Pelvic Floor / innervation
  • Pelvic Organ Prolapse / prevention & control
  • Postpartum Period
  • Pregnancy
  • Quality of Life
  • Urinary Incontinence / prevention & control
  • Vagina
  • Young Adult