Breathing Patterns Regulated by Tension-Free Abdominal Breathing Training Are Associated With Improved Pelvic Floor and Brain Function in Postpartum Females With Pelvic Floor Dysfunction: A Pilot Feasibility Study

Background: We investigated the effects of breathing patterns regulated by tension-free abdominal breathing training on pelvic floor, mood, fatigue, sleep, and brain function in postpartum women with pelvic floor dysfunction. Postpartum women commonly present with varying degrees of pelvic‑abdominal injuries, which directly impair pelvic‑abdominal motor function. Tension‑free pelvic‑abdominal respiratory training modulates pelvic‑abdominal movements via respiratory exercises, and this study intends to investigate its effects on pelvic floor and brain function in postpartum females. Methods: Medical records of postpartum women with pelvic floor dysfunction who underwent tension-free abdominal breathing training were retrospectively collected. Pre- and post-treatment brain function test indicators and scores from the Pelvic Floor Distress Inventory-20 (PFDI-20), Edinburgh Postnatal Depression Scale (EPDS), Fatigue Scale-14 (FS-14), Pittsburgh Sleep Quality Index (PSQI), and Self-Rating Anxiety Scale (SAS) were recorded to assess treatment effectiveness. Results: A total of 88 postpartum women (40 vaginal deliveries, 48 cesarean sections) were included. Significant differences were observed in PFDI-20 (p < 0.001) and EPDS (p < 0.001) scores following breathing pattern regulation. Brain function assessment showed significant changes in anxiety tendency (p = 0.02), depressive tendency (p < 0.001), introverted brain (p = 0.03), brain inhibition (p = 0.02), and brain stability (p = 0.04). Correlation analysis demonstrated that PFDI-20 scores were positively correlated with EPDS (p < 0.001), SAS (p < 0.001), FS-14 (p < 0.001), and PSQI (p = 0.027) scores. Among brain function indices, PFDI-20 scores were positively correlated with anxiety tendency (p = 0.002) and outside focus (p = 0.01), and negatively correlated with introverted brain (p = 0.043), brain stability (p = 0.016), inner focus (p = 0.042), and brain emptying (p = 0.024). Conclusions: Tension-free abdominal breathing training may warrant further investigation as an intervention for pelvic floor dysfunction in postpartum women, given its potential to restore pelvic floor function, alleviate anxiety and depression, and improve brain function as assessed by electroencephalography (EEG).