A hospital based randomized controlled trial to evaluate the effectiveness of Kegel's exercise on postpartum perineal laxity

Objectives: The objectives of the study are to: (i) Assess the perineal muscle strength of postnatal mothers after vaginal delivery in the experimental and control groups before and after the intervention. (ii) Evaluate the effectiveness of Kegel's exercise on perineal laxity in the experimental group compared to control group. Methods: This single blinded randomized controlled trial at a 1000 bedded tertiary care teaching hospital in India, enrolled 290 postnatal mothers between 20 and 40 years who had vaginal delivery with ≤ 2 on modified Oxford grading scale as measured by per vaginal digital examination. The subjects were randomized into experimental and control groups. The experimental group received instructions to perform Kegel's exercises along with routine postnatal care while the control group received advice on routine postnatal care. Two follow-up assessments were done at 6 and 10 weeks. The primary outcome measure was increase in Oxford grading score. Results: Major findings of the study were: The mean perineal muscle strength assessment scores noted before the intervention and during first and second postintervention assessments were 1.5 ± 0.52, 3.58 ± 0.51 and 4.28 ± 0.57 respectively for the experimental group and 1.56 ± 0.55, 2.41 ± 0.52 and 3 ± 0.51 respectively for the control group. Comparison of these scores between the groups by unpaired t-test yielded p-value of < 0.0001 suggesting high significant difference in favor of the experimental group. However, no additional benefit was observed after Kegel's exercise in the mothers who had episiotomy during vaginal delivery. Conclusion: The Kegel's exercise is effective to reduce perineal laxity and hence should be included as a part of routine postnatal care.