Diastasis Recti Abdominis Research Articles

Effect of Core Stability Exercise in Preventing Diastasis Recti Abdominis among Normal Birth Delivery of Postpartum Mothers: Meta-Analysis

Background: Diastasis Recti Abdominis (DRA) is a separation that occurs in the abdominal muscles, namely between the two rectus abdominis muscles. This separation is precisely in the linea alba which is the midline of the abdomen. DRA is characterized by two things, namely the widening of the inter-recti distance (IRD) and the appearance of a bulge in the abdomen. This is due to stretching and weakness of the linea alba. This study aims to analyze the effect of core stability exercise on reducing diastasis recti abdominis in normal postpartum mothers based on the results of a number of previous primary studies. Subjects and Method : This study uses a meta-analysis method with articles searched using the search keywords "Core stability exercise" AND "diastasis recti abdominis" OR "normal post partum" OR "caliper" OR "ultrasonography" OR "Randomized Controlled Trial" OR "RCT" from PubMed, Google Scholar and Scopus and processed using RevMan 5.3. Results : 9 RCT articles that fit into the inclusion criteria, with a total of 319 samples. Normal post­partum mothers with diastasis recti abdominis who received core stability exercise had an average caliper score of 4.71 units lower than those without core stability exercise, and the effect was statistically significant (SMD= -4.71; 95% CI -8.05 to -1.37; p= 0.060). Normal postpartum mothers with diastasis recti abdominis who received core stability exercise had an average ultrasound score of 0.80 units lower than those without core stability exercise, and the effect was statistically significant (SMD= -0.80; 95% CI -1.62 to 0.02; p= 0.060). In other words, core stability exercise is effective in reducing diastasis recti abdominis in normal postpartum mothers. Conclusion: Core stability exercise has an effect on reducing diastasis recti abdominis in mothers after normal delivery. Keywords: post partum, diastasis recti abdominis, core stability exercise, calipers, ultrasound Correspondence: Feny Oktaviyani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: fenyokta89@gmail.com. Mobile: +6281312500­575. Indonesian Journal of Medicine (2022), 07(02): 188-199 https://doi.org/10.26911/theijmed.2022.07.02.07

Efficacy of Standardized Rehabilitation in the Treatment of Diastasis Rectus Abdominis in Postpartum Women.

PurposeThe incidence of diastasis rectus abdominis (DRA) in parturients is continuously increasing, which may cause uncomfortable and affect the quality of life. The present study aims to retrospectively summarize the experience and efficacy in the treatment of DRA via standardized rehabilitation procedures in Eastern China.MethodsThis retrospective study included the parturients with DRA admitted to the Xishan People’s Hospital of Wuxi between January 2017 and May 2021. Patients were separated into standardized rehabilitation group (SR) and non-standardized rehabilitation group (non-SR). The outcomes were the change in rectus abdominis separation and Physical Functioning Scale (PFS). Measurement data were compared between the two groups, and multivariate linear regression was used to analyze the factors associated with the standardized rehabilitation process. P values < 0.05 were considered statistically significant.ResultsAmong a total of 294 patients with DRA who were included in the study, 171 patients were treated with SR (SR), and the other 123 patients were treated without SR process (non-SR). Compared with non-SR, the separation of the rectus abdominis was significantly reduced in SR after standardized rehabilitation treatment (p value < 0.0001). The multiple linear regression model analysis results suggested that standardized rehabilitation was an independent factor influencing the prognosis of DRA in parturients (p < 0.0001). In addition, the quality of life of the study group was significantly improved (p < 0.0001).ConclusionStandardized rehabilitation method revealed high efficiency in treating DRA in postpartum women and could improve the quality of life of parturients.

O16 THE TOR-CONCEPT (TRAINING-OPERATION-REHABILITATION) APPLIED TO A COHORT OF POST-PARTUM WOMEN WITH SYMPTOMATIC DRA (DIASTASIS RECTI ABDOMINIS). EVALUATION OF PHYSICAL FUNCTION AND QUALITY OF LIFE ONE YEAR AFTER SURGERY

Abstract Aim Management of diastasis recti abdominis (DRA) differs regarding core training, surgical repair methods and post-operative rehabilitation. The purpose of this prospective cohort study was to evaluate the effect of a novel concept of treatment for DRA, the TOR-concept (Training, Operation and Rehabilitation). The concept includes preoperative evaluation of symptoms and instructed abdominal core training; tailored surgical repair of the DRA; and an individualized postoperative rehabilitation program. Material and Methods A cohort of seventy-five post-partum women with diagnosed DRA and training resistant core dysfunctions were evaluated and included to the study during 2018-2020. After surgery, all participants underwent an individualized supervised rehabilitation program with progressive increasing load for four months. Physical function was registered preoperatively and one year after surgery with the disability rating index (DRI) questionnaire. Quality of life (QoL) was assessed with the SF-36 questionnaire. The DRA and the surgical result were assessed with ultrasonography before and one year after surgery. Results Sixty-nine participants, 92%, completed the study. There were no DRA-recurrences at the 1-year follow-up. Early results shows that self-reported physical function, (DRI), improved in 88.8 % of patients, with a mean score improvement of 78.5 %. Quality of life, (SF-36), improved significantly compared with the preoperative scores, and reached a level similar to, or higher than, the normative Swedish female population. Conclusions In this cohort of post-partum women with DRA combined with core instability symptoms resistant to training, surgical reconstruction within the TOR-concept resulted in a significant improvement of physical function and QoL.

A Possible Pathway from Exercise and Movement to Healing Pregnancy-related Diastasis RectiAbdominis (PDRA)

Pregnancy-related Diastasis Rectus Abdominis (PDRA) is a prevalent condition.

Normal width of the linea alba, prevalence, and risk factors for diastasis recti abdominis in adults, a cross-sectional study

AimThe prevalence and definition of diastasis recti abdominis (DRA) is under debate. This retrospective cross-sectional study evaluated the interrectal distance and the prevalence of DRA in computed tomography (CT) in an asymptomatic population.Materials and methodsPatients undergoing CT scans for suspected appendicitis or kidney stones from 01/2016 to 12/2018 were screened retrospectively to participate. A study population with equal distribution according to gender and age (18–90 years) was generated (n = 329 patients) and the interrectal distance was measured at six reference points.ResultsDRA (defined as > 2 cm at 3 cm above the umbilicus) was present in 57% of the population. The 80th percentile of the interrectal distance was 10 mm at the xiphoid (median 3 mm, 95% confidence interval (CI) 0–19 mm), 27 mm halfway from xiphoid to umbilicus (median 17 mm, 95% CI 0–39 mm), 34 mm at 3 cm above the umbilicus (median 22 mm, 95% CI 0–50 mm), 32 mm at the umbilicus (median 25 mm, 95% CI 0–45 mm), 25 mm at 2 cm below the umbilicus (median 14 mm, 95% CI 0–39 mm), and 4 mm halfway from umbilicus to pubic symphysis (median 0 mm, 95% CI 0–19 mm). In the multivariate analysis, higher age (p = 0.001), increased body mass index (p < 0.001), and parity (p < 0.037) were independent risk factors for DRA, while split xiphoid, tobacco abuse, and umbilical hernia were not.ConclusionThe prevalence of DRA is much higher than commonly estimated (57%). The IRD 3 cm above the umbilicus may be considered normal up to 34 mm. To avoid over-treatment, the definition of DRA should be revised.

Efficacy of a Core Strengthening Program for Diastasis Rectus Abdominis in Postpartum Women: A Prospective Observational Study

Background: Diastasis rectus abdominis (DRA) is characterized by a widening between the rectus abdominis muscles and thinning of the linea alba. It is common during pregnancy and may contribute to postpartum low back pain (LBP) and stress urinary incontinence (SUI). Core strengthening is thought to improve DRA, but there is no widely accepted exercise program. Objectives: To assess changes in interrectus distance (IRD) and participant-reported outcomes (PROs) after an online core strengthening program in postpartum women with DRA. Study Design: Prospective observational study. Methods: Forty-three postpartum women (36.7 ± 3.5 years) with DRA, which was diagnosed as an IRD 2.0 cm or more using musculoskeletal ultrasound, participated in a 12-week online core strengthening program focused on daily transversus abdominis activation with coordinated breathing and pelvic floor muscle engagement. IRD and PROs were assessed at baseline and 12 weeks. A subset of 19 women participated in an additional 12-week maintenance phase, and outcomes assessments were performed at 24 weeks. Results: The 12-week online core strengthening program significantly decreased IRD above and below the umbilicus at rest (slope [95% confidence interval]: −0.56 [−0.74, −0.38] and −0.26 [−0.45, −0.06]; P < .001 and P = .009, respectively) and below the umbilicus during contraction (−0.39 [−0.58, −0.20]; P < .001). Improvements in LBP-related disability (P = .002) and SUI (P = .001) were also observed. Participation in the maintenance phase significantly improved IRD at 24 weeks compared with 12 weeks (P < .0125). Satisfaction averaged 7.43 ± 2.23. Conclusions: The 12-week online core strengthening program reduced IRD and improved LBP-related disability and SUI. Program participation for 12 additional weeks further reduced IRD. These results suggest that the online core strengthening program can be used in postpartum women with DRA.

Nurses' Perspectives of the Need for Physical Therapy Services During an Acute Postpartum Stay: A Focus Group

Hypothesis/Purpose: Complications in the postpartum period can include pain, urinary incontinence, diastasis recti abdominis, and pelvic floor injury. Physical therapists are in a unique position to address these concerns during the acute postpartum stay. However, there is a lack of consensus regarding the role of physical therapy (PT) in this patient population. Mother-Baby (MB) nurses work closely with postpartum mothers; therefore, the purpose of this study was to gain nurses' perspectives of their knowledge of and need for PT in the acute postpartum setting. Subjects: Nine MB nurses and 1 newly graduated nurse with MB experience from 2 hospitals near Winchester, Virginia, participated. Materials/Methods: Contact was made with nurse managers to arrange a time for the focus group. A demographic questionnaire was distributed prior to the session. A student moderator led the semistructured interview with preselected open-ended questions. The focus groups were audio/video recorded and transcribed. Transcriptions were used for theme coding and concept map development. Results: Five participants were present for each focus group. Four main themes and 1 subtheme emerged. These included lack of understanding of PT scope of practice with a subtheme of special circumstances, limited time, role overlap, and appropriate timing of PT. Lack of understanding of PT scope of practice was the overarching theme. Conclusion: MB nurses demonstrated a limited understanding of the PT scope of practice and their potential role postpartum. Further education and interdisciplinary collaboration may be beneficial to enhance postpartum care in the United States.

Connections Between Perceived Social Support and the Body Image in the Group of Women With Diastasis Recti Abdominis.

Background: The psychological features of the body image and the role of perceived social support for women with diastasis recti abdominis (DRAM) is significant for the treatment of this group of patients, but it is difficult to identify research on this topic. We aimed to search for similarities and differences between postpartum women with DRAM in terms of their psychological features of the body image and perceived social support from the partner, family and friends.Methods: Three hundred forty-five Polish women with DRAM were asked to fill the The Multidimensional Body-Self Relations Questionnaire (MBSRQ), The Multidimensional Scale of Perceived Social Support (MSPSS) and The Drawing Self-Assessment Sheet. Data analysis included the stepwise regression analysis and k-cluster analysis.Results: We identified several predictors in the group of women with DRAM. Social support of partner, family, and friends are the predictors of self-assessment of general body appearance. Social support of family is a predictor of self-assessment of the health of the body. Social support of friends is a predictor of self-esteem of weight and fear of gaining weight. Moreover, three clusters of women with DRAM were found. Type 1—women with DRAM with one child and low self-esteem of the general appearance of the body, low self-esteem of health condition of the body, high self-esteem of weight, and fear of weight gain, and low level of social support; Type 2—women with DRAM with three or more children and low self-esteem of the general appearance of the body, low self-esteem of health condition of the body, high self-esteem of weight and fear of weight gain, and high level of social support; and Type 3—women with DRAM with two children and high self-esteem for the general appearance of the body, high level of self-esteem for health of the body, low self-esteem of weight and fear of weight gain, and high levels of social support.Conclusions: Social support is a predictor of body image in women with DRAM, but there are other factors that influence body acceptance more in this group of women. Furthermore the three clusters featured in the study may help in treating women with DRAM.

English

BACKGROUND Pregnancy creates a radical change in a woman’s life. The physical, hormonal, and psychosocial changes during pregnancy affect the quality of life in post pregnancy phase. Diastasis recti abdominis (DRA) is one of the most common problems seen in post-partum period. DRA is a separation between two bellies of the rectus abdominis muscle connected by the linea alba. A significant DRA, if left untreated at the right time can lead to delirious complications. Prior researches have shown that diastasis recti abdominis is a very common condition seen in the post-partum period. Previous studies have shown that DRA can be reduced with help of an abdominal binder but have very less recorded data. Fewer studies have been conducted showing the combined effect of use of abdominal binder with core strengthening exercises in reduction of DRA. The purpose of this study was to find out the effect of a conventional abdominal binder on diastasis recti abdominis in post-partum women and determine the effect of a conventional abdominal binder on diastasis recti abdominis in post-partum women. METHODS This experimental study included 9 post-partum women with significant DRA. Their age ranged from 25 - 30 years, body mass index (BMI) less than 40 kg/m2. The outcome measures included DRA, lumbar lordosis measurement, low back pain and disability in post-partum period. The subjects were instructed to use an abdominal binder and were taught core strengthening exercises up to 3 months post-partum. RESULTS The obtained results show that there is statistically significant reduction in DRA after use of conventional abdominal binder and exercises. The before treatment values for mean and standard deviation at, above and below umbilicus were 59.39 ± 14.24, 51.87 ± 12.37, 38.15 ± 12.13 respectively which reduced to 41.19 ± 12.21, 37.76 ± 12.98, 30.76 ± 8.94 respectively after using conventional binder with exercises for 3 months. The P value at all three levels of measurements namely - at, above and below umbilicus was &lt; 0.0001 which is statistically considered to be extremely significant. The study duration was of 3 months. CONCLUSIONS The findings conclude that the mean value of DRA decreases with the help of abdominal binder and core strengthening exercise regime. Hence, the abdominal binder and core strengthening exercises were effective in reducing the DRA. KEY WORDS Abdominal Binder, Diastasis Recti Abdominis, Rectus Abdominis, Core Strengthening, Post-Partum

Effect of Russian Current Followed by Exercise in Postpartum Diastasis Recti Abdominis: A Single Case Study

Effect of Russian Current Followed by Exercise in Postpartum Diastasis Recti Abdominis: A Single Case Study

Muscle elasticity is different in individuals with diastasis recti abdominis than healthy volunteers

ObjectiveTo determine the value of shear wave elastography (SWE) in assessing abdominal wall muscles, including rectus abdominis (RA), external oblique muscle (EO), internal oblique muscle, and transversus abdominis (TrA) in patients with diastasis recti abdominis (DRA) and healthy controls.MethodsFrom October 2018 to December 2019, 36 postpartum DRA patients and 24 nulliparous healthy women were identified. Inter-rectus distance (IRD) measurements were taken by B-mode ultrasound. Shear wave speed (SWS) values were acquired by one operator at ten specific locations. Clinical and ultrasound variables, including demographics, IRD, muscle thickness, and muscle SWS, were compared between the two groups using Student’s t test or Fisher's exact test. Pearson correlation analyses were conducted for the variables of IRD, muscle thickness, and SWS in the 36 DRA patients.ResultsThe maximum diameter of recti abdominus separation was located at the umbilicus in DRA patients (4.59 ± 1.14 cm). The SWS value was significantly lower in the RA (p = 0.003) and higher in the TrA muscle (p < 0.001) in DRA patients compared with the age-matched controls. However, SWS in both muscles (RA and TrA) showed a statistically positive correlation with IRD (p < 0.05). In addition, the SWS value in EO statistically decreased in DRA patients compared with the healthy controls (1.65 ± 0.15 vs. 1.79 ± 0.14, p = 0.001).ConclusionsThe application of SWE to abdominal wall muscles in DRA patients is feasible. The correlation between SWS value and IRD in RA should be interpreted with caution.

An ultrasound observation study on the levator hiatus with or without diastasis recti abdominis in postpartum women

Introduction and hypothesisWe hypothesized that differences in post-partum levator hiatus (LH) measurements, as well as the area of urethra and bladder (AUB), viewed under ultrasound, correlate with diastasis rectus abdominis (DRA) occurrence. The primary objective of this study is to determine ultrasound parameters available for diagnosing DRA in post-partum women. We compared LH and AUB measurements under ultrasound in primiparous women, with and without DRA, at 24–26 weeks postpartum.MethodsOne hundred ninety-four women underwent routine examination, including a self-made clinical symptoms questionnaire, DRA evaluation, and LH and AUB measurements. Independent samples t- and chi-squared tests were used to compare the differences between women with and without DRA.ResultsDRA incidence was significantly higher among those who underwent cesarean section (CS) than for vaginal delivery (VD) (P = 0.038). DRA patients could potentially have urinary urgency, frequency, pain, dysuria, and perineal tears. Additionally, statistically significant differences were found between VD patients, with or without DRA, in the resting LH transverse diameter (TrD) (P = 0.032) and the area of the levator hiatus (ALH) (P = 0.048) as well as AUB at Valsalva (P = 0.049). No differences, however, were found between the DRA and no DRA groups for all those measurements among women who had cesarean deliveries.ConclusionsDRA was more likely in post-CS women. Furthermore, the results showed a plausible association between DRA occurrence and LH expansion, especially in women with VD under rest and Valsalva. This could be useful for developing therapeutic plans based on these parameters for post-partum rehabilitation of women with DRA to avoid long-term complications.

Correlation of Diastasis of Rectus Abdominis Muscle in Patients with Low Back Pain in Lahore

Rectus abdominis is a major core muscle, its separation cause diastasis of rectus abdominis muscle. Core muscles are spinal stabilizer its separation cause increase load on spine and causing low back pain. Diastasis of rectusabdominis mainly occur due to thinning of linea alba.&#x0D; Objective:Diastasis Rectus Abdominis and LBP are interchangeable and we want to nd out theirassociation.&#x0D; Methodology:By using a standard caliper method and standard ngertip deepen clinical DRA measurement method was performed on 134 participants From which 126 participants had Low back pain only 8 Participants didn't havelow back pain.&#x0D; Results: It was concluded that 81 (64%) participants out of 134 participants had DRA as while 67(84.8%) participants out of 79 had higher BMI which means there BMI values present between 25-29.5 had a DRA. Only 9(81.2%) participant out of 11had BMI more than 30 have DRA as well. 20 (54.1%) out of 37 males had DRA.&#x0D; conclusion: It was concluded that there was a strong evidence present which shows that DRA and Low back pain was highly associated with each other which indicate that Diastasis also cause Low back pain. Especially in those who hadhigher BMI value. It was more common in males.

Perceived Benefits and Barriers to Prenatal and Postpartum Exercises Among Child Bearing Women in Kano, Nigeria

BACKGROUNDPregnancy is a stressful phenomenon experienced by women, during which the body experiences dramatic anatomical, physiological, and psychological changes.AIMThe study examined perceived benefits and barriers to prenatal and postpartum exercises among pregnant women in Kano.METHODSThe study was a descriptive survey in which 400 consenting pregnant women attending antenatal clinic were recruited for a period of 3 months (November 2019 to January 2020, using systematic random sampling technique. A structured interviewer-administered questionnaire was utilized to elicit responses and the data obtained was analyzed using descriptive statistics of mean, standard deviation, and frequency distribution.RESULTSFindings showed that the respondents have a mean age of 26.86 ± 5.4 years which ranges from 17–47 years. Prenatal exercises may be associated with the prevention of excessive weight gain and/or gestational diabetes and/or preeclampsia. The study further revealed that most of the respondents agreed that postpartum exercises prevents vaginal and uterine prolapse and urinary incontinence, helps in losing post pregnancy body weight and prevents diastasis recti abdominis. The major barriers identified included lack of access to facilities, lack of family support, and cultural factors.CONCLUSION AND RECOMMENDATIONThe study concludes that there is a positive perception of the benefits of prenatal and postpartum exercises and therefore, recommends that maternity care givers should provide accurate, adequate, and relevant information and advocate increased social and family support.

Women with diastasis recti abdominis might have weaker abdominal muscles and more abdominal pain, but no higher prevalence of pelvic floor disorders, low back and pelvic girdle pain than women without diastasis recti abdominis

ObjectiveTo investigate whether women with diastasis recti abdominis (DRA) have weaker abdominal muscles and higher prevalence of pelvic floor disorders (PFD), low back, pelvic girdle and abdominal pain than women without DRA. DesignCross sectional study of women with and without DRA. SettingUniversity study. ParticipantsSeventy-two parity and age matched women with and without DRA. Main outcome measuresMaximal abdominal muscle strength and endurance were assessed with a dynamometer and with a curl-up test. Women reported whether they experienced PFD, low back pain, pelvic girdle pain or abdominal pain. Those experiencing PFD or pain completed the Pelvic Floor Distress Inventory-short form 20 (PFDI-20), the Oswestry Disability Index (ODI), the Pelvic Girdle Questionnaire (PGQ) or questions about abdominal pain, respectively. ResultsMaximal abdominal strength standing with 30° hip flexion was significantly lower in women with DRA (mean difference −12.9Nm, 95%CI: −24.4 to −1.5; P=0.028), but adjusted analyses showed no significant difference (mean difference −11.9Nm, 95%CI: −26.5 to 2.6; P=0.106). Adjusted analyses showed significant higher prevalence of abdominal pain in women with DRA (OR: 0.02, 95%CI: 0.00 to 0.61, P=0.026). There was no difference between the groups in PFD, low back and pelvic girdle pain. ConclusionWomen with DRA tend to have weaker abdominal muscles and higher prevalence of abdominal pain, but no higher prevalence of PFD, low back or pelvic girdle pain than women without DRA.

561 The effect of a postpartum diastasis rectus strengthening program

Diastasis rectus abdominis (DRA) is a separation of the abdominal wall that often occurs in pregnancy, including up to 60% of postpartum women. Several studies have shown core strengthening improved DRA, but there is no widely accepted exercise program directed at this condition. Our objective was to determine the effect of a core strengthening program on inter-rectus distance (IRD) in postpartum women diagnosed with diastasis rectus abdominis (DRA). We conducted a prospective non-randomized trial in which forty healthy, non-pregnant women who were 3-36 weeks postpartum were consecutively assigned to Group A (19) or Group B (21). DRA was diagnosed as an IRD ≥ 2.0cm on ultrasound. Group A participated in the online core training program for 12 weeks followed by a maintenance phase for 12 weeks, while Group B participated in the initial 12 weeks training program only. A single investigator performed all ultrasound measurements, and participants were asked to forgo all exercises outside of the program for its duration until final measurements were collected. The 12 week core strengthening program significantly decreased IRD above and below the umbilicus at rest (-0.57cm; p<0.001, -0.31; p=0.004, respectively), and below the umbilicus during contraction (-0.4cm; p<0.001). Significant improvements in stress urinary incontinence (SUI) p=0.002 and lower back pain (LBP) p=0.027 were also observed in both groups. Group A had significantly lower IRD at 24 weeks (2.79cm) compared to 12 weeks (1.95cm). The online 12-week core strengthening program reduced IRD, and improved SUI and LBP. Participation for an additional 12 weeks resulted in further IRD reduction. These results suggest that a core strengthening program is effective and safe at reducing IRD, and that continuation for 24 weeks further improves DRA.

Correlates of Inter-Rectus Distance in Nigerian Parous Women

ABSTRACT Background: Diastasis Recti Abdominis (DRA) or increased inter-rectus distance (IRD) is among the most common pregnancy-related physical disorders in women. Studies are scarce on its correlates in an African population. Objectives: The aim of this study was to determine anthropometric and maternal correlates of DRA in Nigerian parous women. Materials and Methods: Eighty nine (89) consenting parous women (20–45 years) participated in this observational study. The IRD was measured with an electronic digital caliper at the umbilical level alongside other anthropometric measurements (weight, height, waist circumference (WC), hip circumference (HC)). Information on participants’ age, mode of delivery (MOD), parity, and age of last child (AOLC) was obtained. Data were analyzed with descriptive statistics and inferential statistics of Pearson’s and Spearman’s rank correlations, respectively, with subsequent linear regression analysis at an alpha level of P &lt; 0.05. Results: The IRD significantly correlated with WC (r= 0.213, P = 0.045) and waist-to-hip ratio (WHR), (r = 0.357, P = 0.001). Significant regression equations were determined for the prediction of IRD based on WC and WHR. However, the other variables studied showed no significant (P &gt; 0.05) correlation with IRD. Conclusion: WC and WHR are predictors of IRD in parous women, and these should be considered as important variables in the management of DRA associated with pregnancy.

Diastasis recti abdominis - what may cause it in postpartum women?

Diastasis recti abdominis - what may cause it in postpartum women?

Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: Prevalence, risk factors and its impact on life.

This study aimed to obtain the incidence of diastasis recti abdominis (DRA) and analyse possible risk factors in adult females. Moreover, the relationships between DRA and lower back pain, pelvic floor function and quality of life were also analysed. Diastasis recti abdominis is a separation of the abdominal muscles at the linea alba. Currently, studies on the prevalence rates, risk factors and consequences of DRA are varied. In particular, reports on DRA among adult women are lacking. A one-sample questionnaire study design is used following the STROBE checklist. The inter-rectus distance was measured by computed tomography in 644 women. Custom questionnaires, the Oswestry Disability Index, The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were used to investigate personal information, the subjects' back pain, pelvic floor function and quality of life, respectively. The incidence of DRA was 28.4%. Age, the number of pregnancies, BMI and diabetes were influencing factors for DRA. After age stratification, pregnancy and diabetes were found to be risk factors for DRA in young women, and obesity and diabetes were risk factors for DRA in older women. This study showed that the association between DRA and low back pain was highly significant. Diastasis recti abdominis is common in adult women. Avoiding multiple pregnancies, preventing diabetes and controlling weight may prevent DRA, which may be beneficial for decreasing low back pain in women. The findings have important implications for the health of adult women which can provide the basis for appropriate nursing implementation for DRA patients. The application of specific prevention and intervention measures for the risk factors may reduce the severity of low back pain.

A Supervised Pelvic Floor Training Program Has Minimal Effect on the Prevalence of Postpartum Diastasis Recti Abdominis: A Critically Appraised Paper

Focused Clinical Question: For postpartum primiparous women, will a 16-week, supervised, targeted pelvic floor muscle training program result in a reduced prevalence of diastasis recti abdominis versus education only at discharge? Clinical Bottom Line: We can neither recommend nor caution against a targeted pelvic floor muscle training program to reduce the prevalence of postpartum diastasis recti abdominis.