舒 畅,张璟怡

产后是女性身心恢复的关键时期，妊娠和分娩过程中产生的生物力学和激素变化常常导致一系列功能障碍。盆底肌肉训练（PFMT）被证实能有效降低41%的尿失禁风险和56%的盆腔器官脱垂风险，其效果与训练开始时间、频率和专业指导密切相关[1]。针对腹直肌分离（DRA）的康复研究表明，以核心稳定为导向的呼吸训练方案能在6周内显著减小腹直肌间距（IRD），改善率达90%，而传统训练仅为75%[4][8]。对产后腰-骨盆带疼痛（LBPP）的管理发现，针对躯干肌群的强化训练可使疼痛评分降低2.21分（0-10分VAS量表），功能障碍改善率达1.17个标准差[7]。此外，产后运动还能降低28%的2型糖尿病发病风险，改善血压指标，且不影响母乳质量和婴儿发育[5]。本综述整合最新证据，提出了基于评估-个性化方案-监测的临床实施框架，为产后运动康复的科学实践提供参考。

产后康复；盆底功能障碍；腹直肌分离；骨盆带疼痛；运动处方；核心稳定训练

[1] de Mello Domingos,A.B.,Campos,B.M.T.,dos Santos,L.O.H.,&Silveira,K.P.G.(2025).Indications and Applicability of Pelvic Musculature Training in the Postpartum Period:A Literature Review.SaberDigital,18(1). [2] Lu Zhang;Jingbo He;Quancheng Zhang;Ling Wang.(2025).A Study on 10-Week Combined Aerobic and Resistance Training Exercise Prescription for Female Patients with Pelvic Floor Dysfunction.Healthcare,13(6),592. [3] Ziling Lin;Yanjun Hou;Xueling Chen;Yanping Liu;Xiangbin Wang.(2025).Altered lumbo-pelvic-hip complex muscle morphometry and contraction change in postpartum pelvic girdle pain and asymptomatic subjects:a cross-sectional study.Frontiers in Physiology,15. [4] Chen,C.,Zhang,H.-M.,Shen,L.,He,H.-P.,Ma,Z.-Y.,Zhu,Y.-Q.,Geng,Z.-H.,&Qin,Y.-X.(2025).Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women.Open Medicine,20(1). [5] Paris A T Jones;Amy Moolyk;Stephanie May Ruchat;Muhammad Usman Ali;Karen Fleming;Sarah Meyer;Talia Noel Sjwed;Jenna B Wowdzia;Lauren Maier;Michelle Mottola;Allison Sivak;Margie H Davenport.(2025).Impact of postpartum physical activity on cardiometabolic health,breastfeeding,injury and infant growth and development:a systematic review and meta-analysis.British Journal of Sports Medicine,59(8),539. [6] 庄蕊如,苏文杰,庄婷婷,林天华,林友聪.(2025).体外冲击波联合核心稳定训练对产后腰痛治疗效果的研究.中国康复,40(1),27-31. [7] Ruchat,S.-M.,et al.(2025).Impact of exercise on musculoskeletal pain and disability in the postpartum period:a systematic review and meta-analysis.British Journal of Sports Medicine. [8] Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women–DOAJ.(2025).Open Medicine,20(1).

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