Exercise-Based Sensorimotor Physiotherapy for Postpartum Pelvic Health and Functional Recovery

Effects of a 12-Week Exercise-Based Sensorimotor Physiotherapy Program on Postpartum Pelvic Health and Functional Recovery: A Stratified Randomized Controlled Trial

This study evaluated whether a 12-week exercise-based sensorimotor physiotherapy program could improve pelvic health and functional recovery in postpartum women. Participants were women aged 18-40 years who were between 6 weeks and 6 months after a singleton delivery. They were randomly assigned to either a sensorimotor physiotherapy group or a control group. The physiotherapy group received supervised exercises targeting pelvic floor activation, lumbopelvic motor control, sensory re-education, proprioceptive training, functional stabilization, and biofeedback-assisted training. The control group received standard postpartum education and home advice.

The main outcomes were pelvic motor control and perineal sensory function. Other outcomes included pelvic floor muscle strength, urinary symptoms, pelvic distress, core endurance, postural stability, pain intensity, and health-related quality of life. Outcomes were assessed at baseline, week 6, week 12, and week 24. The study aimed to determine whether structured sensorimotor physiotherapy provides greater benefits than standard postpartum advice and whether recovery patterns differ according to vaginal or cesarean delivery.

This was a prospective, single-center, assessor-blinded, stratified, parallel-group randomized controlled trial conducted in postpartum women. The study was designed to evaluate the effects of a structured 12-week exercise-based sensorimotor physiotherapy program on postpartum pelvic health, lumbopelvic motor control, sensory function, and functional recovery.

Eligible postpartum women were stratified according to delivery mode, vaginal delivery or cesarean delivery, and then randomly allocated to either the Sensorimotor Physiotherapy Group or the Control Group. The intervention group received supervised individual physiotherapy sessions twice weekly for 12 weeks, together with a structured home exercise program. The intervention included pelvic floor activation, lumbopelvic motor control training, proprioceptive exercises, sensory re-education, functional stabilization, and surface electromyography-assisted biofeedback. The control group received standard postpartum education and general home advice.

Outcome assessments were performed at baseline, week 6, week 12, and week 24 by blinded assessors. The primary focus was to determine whether the sensorimotor physiotherapy program improved pelvic motor control and perineal sensory function compared with standard postpartum advice. Secondary outcomes were used to evaluate broader functional and patient-reported recovery, including pelvic floor strength, urinary symptoms, pelvic distress, core endurance, postural stability, pain intensity, and health-related quality of life. Delivery mode was examined as an exploratory factor that could influence recovery patterns.

Inclusion Criteria:

• Women aged 18-40 years.
• Postpartum women between 6 weeks and 6 months after delivery.
• Singleton delivery.
• Vaginal delivery or cesarean delivery.
• Ability to understand and perform the required assessment procedures.
• Ability to participate in the exercise-based intervention procedures.
• Provision of written informed consent before enrollment.

Exclusion Criteria:

• Third- or fourth-degree perineal tears.
• Pelvic organ prolapse stage II or higher according to the POP-Q classification.
• Active urinary tract infection or genital infection.
• Previous pelvic or abdominal surgery unrelated to cesarean delivery.
• Neurological conditions affecting lumbopelvic motor control.
• Musculoskeletal conditions affecting lumbopelvic motor control.
• Chronic pelvic pain syndromes.
• Psychiatric disorders limiting participation.
• Participation in structured physiotherapy or pelvic rehabilitation within the preceding 6 months.