The Effects of an Exercise Program on Diastasis Recti Abdominis in Pregnant Women

Abstract

Ms Falzone, Ms McCaslin, Ms Patel, and Ms Ulery were enrolled the the Master of Science Degree in Physical Therapy at Columbia University at the time data was collected for this study. This research was presented at Combined Sections Meeting of the APTA, Boston, MA, 2002 and received the 2002 Research Award from the Section on Women's Health. Approvals: This project was reviewed and approved by the Columbia University and Columbia Presbyterian Institutional Review Board, #9906. Background: Diastasis Recti Abdominis (DRA), a separation of the 2 bellies of the rectus abdominis at the linea alba, may occur in more than half of all pregnancies. Due to hormonal changes and a growing uterus, the abdominal muscles become over-stretched and weak, compromising posture, trunk stability, respiration, trunk motion, and vaginal delivery. Exercise to strengthen the abdominal musculature during pregnancy may affect the presence and size of DRA, however, no research has specifically examined this relationship. Purpose: The purpose of this project was to determine the effect of an abdominal strengthening exercise program on the presence and size of DRA in pregnant women. Study Design: A 2 group, between subjects, quasi-experimental post-test design. Methods: Subjects were comprised of 8 pregnant women participating in an abdominal exercise program and 10 non-exercising pregnant women. Diastis recti abdominis was measured using a digital caliper at 3 marked sites along the midline of each subject's abdomen: 4.5 cm above the umbilicus, at the umbilicus, and 4.5 cm below the umbilicus. Two measurements were taken at each site, and the average was used for statistical analyses. Descriptive statistics were generated, and independent t-tests were performed on each subject characteristic. An analysis of covariance was computed with the number of previous pregnancies as the covariate to control for the difference between the subject groups. Results: Ninety percent of non-exercising pregnant women exhibited DRA while only 12.5% of exercising women had the condition. The mean DRA located 4.5 cm above the umbilicus was 9.6 mm (± 6.6) for the exercise group and 38.9 mm (± 17.8) for the non-exercise group. The mean DRA located at the umbilicus was 11.4 mm (± 3.82) for the exercise group and 59.5 mm (± 23.6) for the non-exercise group. The mean DRA located 4.5 cm below the umbilicus was 8.2 mm (± 7.4) for the exercise group and 60.4 (± 29.0) for the non-exercise group. Conclusions: The occurrence and size of DRA is much greater in non-exercising pregnant women than in exercising pregnant women. Because of the integral role the abdominal muscles play in functional activities we recommend examining pregnant and postpartum women for the presence of DRA.