Introduction: Diastasis of the rectus abdominis muscles (DRAM) is the separation of the two rectus abdominis muscles more than 2 cm wide. It often arises as a result of android obesity, dysfunctional abdominal cramp and pregnancy. Untreated diastasis may lead to dangerous heath consequences such as.: abdominal hernia, lower back pain or disorders in pelvis's area. The aim of this study was to determinate the effectiveness of novel physiotherapeutic program in women with diastasis of the rectus abdominis muscles. Material and methods: The study was conducted on a group of 40 women between 20-45 years old (mean 32,32+5,9 year). They all were qualified in obstetric ward of Szpital Bielański in Warsaw. All of them were in the postpartum between 0-3 days after labor and have DRAM greater than 2 cm (measured by palpation on the umbilicus height, 4,5 cm above and below umbilicus). In research group (included 20 women) applied novel physiotherapeutic program aimed at reduction of DRAM. In controlled group (20 women) there was no therapy but only observation of spontaneous reduction of diastasis. The study took 6 weeks. Results: Data analysis had shown 95% effectiveness of novel physiotherapeutic program. Chi-square test has confirmed the difference in DRAM size in both groups (p<0,0001). A statistically significant correlation was demonstrated between width of diastasis and growth of the mother's weight gain in pregnancy, waist-to-hip ratio, BMI, number of delivery and mother's physical activity before and during pregnancy (p<0,05). There wasn't clear correlation between width of diastasis and mother's age or infant's mass (p>0,05). Conclusions: It seems that spontaneous reduction of diastasis of the rectus abdominis muscles is very rare. New physiotherapeutic program is an effective method in DRAM's reduction. The research should be continued in larger group of women and after effectiveness confirmation, program should be introduced in obstetric wards.
Major abdominal surgery decrees efficiency of walking and lung ventilation after 65 year old in early postoperative period. Some techniques of the PNF concept used in improving older patients after the MAS may favourably affect the postoperative increase independence and reduce the time of hospitalization.
Introduction: Lumbopelvic pain (LPP) is clinically diverse and difficult to treat medical problem. Changes during pregnancy and confinement conduce the appearance of pain complaints. LPP proper differential diagnosis and education constitute the basis of properly selected treatment. The aim of the study was to establish the LPP frequency in pregnant women. Additionally, the daily living activities limitations level was defined.Materials and methods : 211 pregnant women took part in the study. The study was performed with the use of advanced online questionnaire. The research tool consisted of: original questionnaire, International Physical Activity Questionnaire -IPAQ (shortened Polish version) and Oswestry Disability Index (ODI).Results: On the basis of conducted studies, the LPP was diagnosed in majority (80.1%) of tested women. There were statistically significant correlations between the pain intensity and age (p = 0.023, r = -0.16) and education (p = 0.013, r = -0.17). It has been proven that there is a statistically significant correlation between the pain intensity, BMI (p = 0.002, r = 0.22) and physical activity level (p = 0.048, r = 0.14). It has been stated that 65.4% research subjects had no significant limitations in performing daily living activities.Conclusions: The lumbopelvic pain applies to majority of pregnant women in the study. The risk of LPP increases with BMI growth. LPP occurs less frequently in women with higher education and in older ones. In majority of cases LPP does not cause limitations in daily living activities.
Introduction: The aim of the study was to assess the influence of the implemented therapeutic programme, which consisted of body posture correction and of change of habits, on the pelvic floor muscle function in women with stress urinary incontinence. Material and methods: The 60 women were randomly divided into two groups: the study population and the clinical control group (subjects received envelopes with numbers of the group: 1- study population aged 38.3 ± 5.54, 2- clinical control group aged 35.5 ± 4.7. We used the following research methods: A personal questionnaire with subjects’ demographics and with questions related to the type of work, physical activity, childbirths and any issues related to the pelvic floor (pre-test), Pelvic floor muscle assessment with the use of the PERFECT Scheme and the Oxford scale palpation examination, sEMG with intravaginal electrode and manometry with an intravaginal probe—pre-test and post-test. Subjective assessment of body posture in the sagittal plane according to the McKenzie methodology. Results: In both groups, VRP (resting vaginal pressure) and resting PFM tension were significantly reduced. The strength and endurance of PFM, tension during MVC and VSP (intravaginal pressure during contraction) increased, with no difference between the groups. SUI decreased significantly, and quality of life improved significantly in both groups. Conclusions: Education of the pelvic floor and changing habits significantly affected the activity of PFM and improved the quality of life in the group of patients with SUI. The posture correction therapy with manual therapy and stretching exercises did not increase this effect.
Introduction: Diastasis recti abdominis (DRA) is both a structural and a functional disorder. It is believed that the main cause of DRA is the extensive stretching of the abdominal wall resulting from pregnancy; yet the condition is also found in men and in children. There are several, seemingly mutually exclusive, DRA risk factors, such as the pathological abdominal muscle tension and chronic exercise deficits. The aim of the study was to determine the factors affecting the size of DRA in postpartum women. Material and methods: The study involved 239 postpartum women. The study was conducted with the use of an online survey. The subjects completed the DRA test, the Beighton test and International Physical Activity Questionnaire. Results: The analysis found DRA in majority of studied women (60.7%). The relationship between the BMI index and DRA was statistically significant (p=0.01). The relationship between surgeries in the abdominal cavity and the DRA was statistically significant, too (p=0.05). We showed that DRA correlates with other pelvic dysfunctions (p=0.03). Conclusions: The most significant risk factors for diastasis recti abdominis in postpartum women are abnormal BMI and surgeries to the abdominal cavity. Diastasis recti abdominis correlates with other dysfunctions, such as: spinal pain, urinary incontinence, peristaltic disorders, sexual disorders, abdominal hernia, groin hernia, lowering of the lesser pelvis organs. Further studies into DRA risk factors under close supervision of a physiotherapist are necessary.
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