The Effect of BeBo® Training and EMG-Biofeedback-Assisted Therapy on Pelvic Floor Muscle Function in Women After Vaginal Delivery and Cesarean Section—A Randomized Controlled Trial

<b>Background/Objectives</b>: Pelvic floor muscle (PFM) training is widely recommended during pregnancy and postpartum as both a preventive and therapeutic intervention. The addition of electromyography (EMG) biofeedback may further enhance training effectiveness. This study aimed to evaluate the effectiveness of a 6-week BeBo^® PFM training program (BeBo^®, derived from the German <i>Beckenboden</i>, "pelvic floor") and to compare it with BeBo^® training combined with EMG biofeedback in women after vaginal delivery (VD) and cesarean section (CS), relative to control groups. <b>Methods:</b> A total of 120 primiparous women (mean age 29.0 ± 1.9 years), 6-8 weeks postpartum after VD (n = 60) or CS (n = 60), were randomly assigned to BeBo^® training, BeBo^®+EMG-biofeedback, or control group. Neuromuscular PFM activity was assessed before and after intervention using surface electromyography (sEMG; Noraxon G2 TeleMyo 2400) with a vaginal probe. <b>Results:</b> Women performing BeBo^® training with EMG-biofeedback demonstrated significantly greater improvements in PFM endurance (<i>p</i> < 0.001, η² = 0.423) in both VD and CS groups compared with controls and BeBo^® training alone. Regarding maximal fast contraction, significant improvements (<i>p</i> = 0.042, η² = 0.097) were observed in both delivery groups within the EMG-biofeedback group, whereas BeBo^® training alone was effective only in the VD group. <b>Conclusions:</b> PFM training based on the BeBo^® concept, particularly when supported by EMG-biofeedback, effectively enhances neuromuscular function, with the greatest benefits observed in women after VD. EMG-biofeedback should be considered as an adjunct in standard postpartum preventive care, with training protocols tailored to delivery mode: relaxation-focused for CS and strengthening-focused for VD.