Effect of Abdominal Physiotherapy in Reduction of Inter Recti Distance in Postpartum Females

Abstract

Aim: To see the effect of abdominal exercises in the recovery of diastasis recti in post natal females. Methodology: A Quasi Experimental study design was used to enroll 40 participants from OPD of Gynecology and Obstetrics from a Tertiary Care Hospital Lahore between ages ranged from 18 to 30 years. Using purposive sampling all postpartum females having diastasis of rectus abdominis muscles with inter recti distance more than 2 fingers width were enrolled. All the study participants received abdominal muscle exercises program for 30 min a day in 8 week program. inter recti distance was measured by using two finger palpation method. All the pre intervention and post intervention data were recorded into a short structured proforma.Results were considered significant for p value ≤ 0.05. Results: 40 participants were selected in this study with an age from 18- 30 years. The inter recti distance was significantly reduced as p value was ≤ 0.05 for both (above umbilicus and below umbilicus) groups. Conclusion: It was observed that abdominal exercises helped in the recovery of diastasis and reduced the separation between the muscles in postpartum women. It also enlightens the importance of the prescription of physiotherapy in reduction of post partum complications. Keywords: Abdominal Exercises, Diastasis Recti, Pregnancy, Postnatal period,

Use of Exercise in the Management of Postpartum Diastasis Recti: A Systematic Review

“…Outcome measurements for IRD were variable across studies, as well. Five studies [18][19][20]22,25 used 2-finger palpation to measure IRD; 6 studies 21,23,24,28,29,31 used ultrasonography to determine IRD; and the remaining 3 studies 26,27,30 used dial calipers for IRD measurements.…”

“…Diastasis rectus abdominus-qualifying criteria varied across studies (Table 2). Six studies [19][20][21][22][23][24] considered an IRD of 2 finger widths the diagnostic threshold. Two studies 25,26 used a 2-cm IRD threshold, and 2 studies 27,28 used a 2.5-cm threshold.…”

“…Exercise program duration varied, as well. The greatest number of studies [19][20][21]26,28 used an 8-week follow-up period, while others used follow-up of 2 weeks, 18 6 weeks, 25,27,31 12 weeks, 23,24,30 and 16 weeks. 22 Frequency of the prescriptive exercise intervention was variable across studies, and, in some cases, 20,23,24,30 specifics of any home exercise program expectations were not well described in the article.…”

“…However, type of exercise varied across studies (Table 3). Studies tested the effects of abdominal draw-in/static abdominal contraction exercises, 18,[22][23][24]26 bridging, 19,29,30 head lift, 18,25,28 4-point arm lift, 19 forms of controlled leg raise/lift, 19,23,25,27,29 pelvic clock rotations, 18 pelvic floor muscle exercises/Kegels, 20,22,26,31 plank, 22,23,25,26,[29][30][31] posterior pelvic tilt, 18,26,27,31 postural positioning/correction, 23,25 reverse trunk twist/u-seat/Russian twist, 26,28,31 sit-ups/reverse sit-ups, 22,[26][27][28] and squats. 18,28 Adjunct modalities included abdominal binding 22,23 controlled breathing/exhalation,…”

“…A single study 25 received a high risk of bias rating due to high risk of bias in missing outcomes data and high risk of bias in selection of reporting results. Using the ROBINS-I assessment to rate the nonrandomized studies of intervention, 3 studies 18,27,29 were considered low risk of bias and 1 study 20 was rated moderate risk of bias due to an unreported postpartum range and poorly defined intervention specifics. A single article received a rating of serious risk of bias, 19 due to potential differences between dropout and completion groups.…”