To analyze the correlation between the surface electromyography (sEMG) characteristics of the pelvic floor in patients with different types of pelvic floor dysfunction (PFD) and their clinical manifestations and prognosis, with an aim to provide a basis for precision rehabilitation.

A retrospective analysis was conducted on 447 patients with PFD who were treated at the Second Affiliated Hospital of Nanjing University of Chinese Medicine from February 2020 to January 2025. These patients were categorized into three groups based on their clinical symptoms: stress urinary incontinence (SUI) group, functional constipation (FC) group, and fecal incontinence (FI) group. sEMG data and clinical information were collected from the patients, and the correlation between electromyographic characteristics and clinical manifestations as well as prognosis was analyzed using the Kruskal-Wallis H test, DSCF method, and Wilcoxon signed-rank test.

There were 227 patients in the SUI group, 141 in the FC group, and 79 in the FI group. The clinical symptoms across all three groups were rated as moderate to severe. The total score and the scores across the five stages of sEMG differed significantly among the three groups (P<0.001). The total score, fast muscle stage score, slow muscle stage score, and endurance test score in the SUI group were significantly higher than those in the FC group and FI group (P<0.01), while the scores in the pre-rest and post-rest stages were lower. The scores in the pre-rest and post-rest stages were significantly higher in the FC group than in the SUI group (P<0.001), while the scores in the fast muscle stage, slow muscle stage, and endurance test were lower. The score in the post-rest stage was significantly higher in the FI group than in the SUI group and FC group (P<0.01), while the total score and the scores in the fast muscle stage, slow muscle stage, and endurance test stage were lower. After intervention with pelvic floor rehabilitation therapy, the clinical symptoms of the three groups were significantly improved (P<0.001), and the sEMG scores increased. The sEMG score in the post-rest stage significantly increased in the FC group (P<0.05); the sEMG scores in the total score, fast muscle stage, and slow muscle stage significantly increased in the FI group (P<0.05); and the total score and sEMG in the pre-rest stage, fast muscle stage, and slow muscle stage significantly increased in the SUI group (P<0.05).

The sEMG characteristics of patients with different types of PFD exhibit significant differences. sEMG can objectively quantify the pelvic floor dysfunction patterns in PFD patients. It is advisable to incorporate sEMG into the routine evaluation system for PFD, and develop precise stratified rehabilitation strategies based on sEMG characteristics to enhance treatment efficacy. This study suggests a correlation between sEMG features and clinical manifestations as well as short-term prognosis, though the underlying mechanisms require further validation via multimodal approaches.