Evaluation of the efficiency of physical exercises for the elimination of diastasis of the rectus abdominal muscles in postpartum women
DOI:
https://doi.org/10.15574/HW.2024.4(173).5255Keywords:
diastasis of rectus abdominis muscles, abdominal wall, diagnosis, treatment, postpartum periodAbstract
Increased pressure on the muscles of the abdominal wall during pregnancy can often cause thinning and expansion of the white line of the abdomen, which is considered diastasis of the rectus abdominis muscles.
Aim - evaluation of the functional consequences and influence of physical exercises on diastasis of rectus abdominis muscles.
Materials and methods. We analyzed 54 patients who were diagnosed with diastasis recti during pregnancy and in the postpartum period. 26 women (the main group) after childbirth underwent a six-month rehabilitation program aimed at reducing diastasis (on average from the first to the seventh month after childbirth), 28 women (the control group) did not undergo a rehabilitation program after the birth of a child. Assessment of systemic complaints related to ventral hernia was carried out using a specialized questionnaire VHPQ (Ventral Hernia Pain Questionnaire), which allowed to assess the quality of daily activities.
Statistical processing of the material was carried out using the Excel 11 program The results were considered probable when the probability ratio was less than or equal to 0.05. The odds ratio was estimated, the confidence interval was set at 95% and defined as ±1.96 standard error.
Results. A statistically significant decrease in the width of the white line was observed in women of both groups 7-8 months after childbirth. Among patients of the main group, this was observed in 73.1% (19 people), and in the control group - in 64.3% (18 people), without a statistically significant difference between the groups. Conservative therapy of diastasis recti of the abdominal muscles made it possible to statistically significantly improve the quality of life of women after childbirth.
Conclusions. In 64.3% of women in the postpartum period, diastasis of rectus abdominis muscles resolves itself within 7-8 months and does not require treatment. A course of six-month physical rehabilitation makes it possible to raise this indicator to 73.1% unreliably. Conservative therapy of diastasis recti of the abdominal muscles in women in the postpartum period allows a statistically significant improvement in the quality of life of patients.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research.
The authors declare no conflict of interest.
References
Benjamin DR, Frawley HC, Shields N et al. (2019). Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review. Physiotherapy. 105(1): 24-34. https://doi.org/10.1016/j.physio.2018.07.002
Blankensteijn LL, Hockx M, Mullender M, Bouman MB, Melenhorst WBWH. (2023, Sep). Clinical significance of diastasis recti: Literature review and awareness amongst health care professionals. J Plast Reconstr Aesthet Surg. 84: 439-446. https://doi.org/10.1016/j.bjps.2023.06.005
Bucaria V, Boccuzzi A. (2021). Autologous Dermal Mesh in Severe Postpregnancy Recti Muscles Diastasis. Aesthetic Plast Surg. 45(1): 198-211. https://doi.org/10.1007/s00266-020-01991-w
Carlstedt A, Bringman S, Egberth M et al. (2021). Management of diastasis of the rectus abdominis muscles: recommendations for Swedish national guidelines. Scand J Surg. 110(3): 452-459. https://doi.org/10.1177/1457496920961000
Daes J, Oma E, Jorgensen LN. (2022, Feb). Changes in the abdominal wall after anterior, posterior, and combined component separation. Hernia. 26(1): 17-27. https://doi.org/10.1007/s10029-021-02535-0
Hernández-Granados P, Henriksen NA, Berrevoet F et al. (2021). European Hernia Society guidelines on management of rectus diastasis. Br J Surg. 108(10): 1189-1191. https://doi.org/10.1093/bjs/znab128
Gluppe SB, Ellström Engh M, Bø K. (2023, Jul). Curl-up exercises improve abdominal muscle strength without worsening inter-recti distance in women with diastasis recti abdominis postpartum: a randomised controlled trial. J Physiother. 69(3): 160-167. https://doi.org/10.1016/j.jphys.2023.05.017
Gluppe S, Engh ME, Bø K. (2021, Nov-Dec). What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis. Braz J Phys Ther. 25(6): 664-675. https://doi.org/10.1016/j.bjpt.2021.06.006
Kaya AK, Menek MY. (2023, Jun). Comparison of the efficiency of core stabilization exercises and abdominal corset in the treatment of postpartum diastasis recti abdominis. Eur J Obstet Gynecol Reprod Biol. 285: 24-30. https://doi.org/10.1016/j.ejogrb.2023.03.040
Swedenhammar E, Strigård K, Emanuelsson P, Gunnarsson U, Stark B. (2021, Sep). Long-term follow-up after surgical repair of abdominal rectus diastasis: A Prospective Randomized Study. Scand J Surg. 110(3): 283-289. https://doi.org/10.1177/1457496920913677
Vasyliuk SM, Petrash AV. (2024). Ultrasound measurement of the width of the linea alba in patients with diastasis recti abdominis. Scientific bulletin of Uzhhorod University. Series "Medicine". 1(69): 11-15. https://doi.org/10.32782/2415-8127.2024.69.2
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Ukrainian Journal Health of Woman
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
