Between September 2017 and September 2018, 108 females with weak pelvic floor muscles determined by vaginal palpation, who underwent a routine postpartum examination of pelvic floor function were recruited to form the postpartum group, and 116 healthy nulliparous female volunteers from gynecological outpatient care were recruited to form the nulliparous group. The postpartum group periods were 3–12 months, which avoided the influence of natural recovery of diastasis recti (20). The ethics approval number for this trial is KY2016-203. All participants provided written informed consent. The exclusion criteria were as follows: (I) the inability to perform the head-lift posture or Valsalva maneuver; (II) poor healing of the cesarean section incision or local skin infection; (III) participation in abdominal muscle training or rehabilitation of the pelvic floor muscles after delivery; and (IV) avulsion of the levator ani causing severe pelvic organ prolapse (POP).

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