The impact of electromyographic (EMG)-biofeedback assisted training on the function of the pelvic floor muscles in women after vaginal and cesarean delivery

Before starting the research, all participants will be assessed: strength and endurance of the pelvic floor muscles with the help of palpation, EMG and perineometer, bladder diary, UDI-6 and IIQ-7 questionnaire, SES Self-assessment scale, changes in KHQ quality of life indicators and Questionnaire of the Quality of Women's Sexual Life. Randomized controlled trials will be carried out on a group of not less than 100 patients aged 25-35 years, after the first vaginal delivery or after the first caesarean section, which will be randomly divided into groups: Arm 1: Vaginal delivery Bebo® group A group of women after vaginal delivery underwent a 6-week, each session according to the Bebo® concept runs for one hour . The training is conducted individually, by a qualified therapist, twice a week. We will monitor attendance using the attendance list. The Bebo® concept - is based on five exercise groups, which are: awareness exercises, mobilization exercises, strengthening exercises, relaxation exercises, and the integration of pelvic floor muscles in everyday activities. Each group of exercises will last approximately 10 minutes. Arm 2: Vaginal delivery Bebo®+ EMG group A group of women after vaginal delivery underwent a 6-week, each session according to the Bebo® concept runs for one hour , supported by a 10-minute EMG-biofeedback training. The training is conducted individually, by a qualified therapist, twice a week. The group, apart from exercises according to the Bebo® concept, will perform a 10-minute EMG-biofeedback training. Its aim will be to obtain conscious tension of the pelvic floor muscles with a strength corresponding to 20, 50, 80% of the previously measured maximum contraction and to maintain the tension at the previously indicated level for a preset time: e.g. 3, 5, 10 seconds, as well as muscle relaxation. The contraction time will be determined for each patient individually by the therapist. The biofeedback device will be inserted into the vagina so that participants may modify the tension of the pelvic floor muscles based on feedback from the device. Arm 3: Cesarean delivery Bebo® group A group of women after cesarean delivery underwent a 6-week, each session according to the Bebo® concept runs for one hour. The training is conducted individually, by a qualified therapist, twice a week. Arm 4: Cesarean delivery Bebo® + EMG group A group of women after cesarean delivery underwent a 6-week, each session according to the Bebo® concept runs for one hour , supported by a 10-minute EMG-biofeedback training. The training is conducted individually, by a qualified therapist, twice a week.