Efficacy of Biofeedback-Assisted Electrical Stimulation Combined with Rectus Abdominis Training for Pelvic Floor Rehabilitation in Community-Dwelling Middle-Aged and Older Women

Objective This study aims to evaluate the clinical efficacy of biofeedback electrical stimulation targeting the pelvic floor muscles in combination with rectus abdominis therapy for improving pelvic floor function in community-dwelling middle-aged and elderly women, with the goal of informing evidence-based practices in community healthcare settings. Methods A total of 150 female patients diagnosed with pelvic floor dysfunction combined with diastasis recti abdominis, treated at the Community Health Service Center , between 2023 and 2025, were enrolled in this study. According to the order of outpatient visits, participants were randomly assigned into a control group and an observation group, with 75 cases in each. The control group received pelvic floor muscle training combined with pelvic floor biofeedback electrical stimulation therapy. The observation group received the same treatment as the control group, with the addition of biofeedback electrical stimulation therapy targeting the rectus abdominis. Pelvic floor surface electromyography (sEMG) parameters, pelvic floor muscle strength, degree of pelvic organ prolapse, sexual function, urinary incontinence scores, and quality of life scores were recorded before and after treatment. Intergroup and intragroup comparisons were performed to assess clinical efficacy. Results Statistically significant improvements were observed in both groups post-treatment (P < 0.05), and the observation group demonstrated superior outcomes in all measured parameters compared to the control group (P < 0.05), including pelvic floor muscle strength, organ prolapse scores, incontinence severity, sexual function, quality of life, rectus abdominis separation, and pelvic floor EMG indicators. Conclusion Combined biofeedback electrical stimulation of the pelvic floor and rectus abdominis offers superior clinical outcomes over pelvic floor therapy alone. It significantly enhances muscle function, reduces pelvic organ prolapse and urinary incontinence, improves sexual function and quality of life, and decreases inter-rectus distance in DRA patients. This approach is suitable for wider application in community-based rehabilitation of middle-aged and older women.