The Effect of Core Exercise Using Online Videoconferencing Platform and Offline-Based Intervention in Postpartum Woman with Diastasis Recti Abdominis

Abstract

To investigate the efficacy of exercise intervention using a real-time video conferencing platform (ZOOM) on inter-recti distance, abdominal muscle thickness, static trunk endurance, and maternal quality of life, 37 women with diastasis recti between six months and one year postpartum were randomly divided into the online (n = 19) and offline (n = 18) groups. The online group underwent 40-min trunk stabilization exercise sessions twice a week for six weeks, through a real-time video conference platform, while the offline group attended the same program in person. The inter-recti distance and muscle thickness between the abdominal muscles were measured by rehabilitation ultrasound imaging, the Torso endurance test was used to compare the static trunk endurance, and the maternal quality of life questionnaire (MAPP-QOL, score) was applied. Significant improvements were observed in the inter-recti distance between the rectus abdominis, abdominal muscle thickness, static trunk endurance, and maternal quality of life in both groups (p < 0.001); a more significant improvement was observed in the offline group. No significant differences were observed between groups except for the left rectus abdominis thickness and Psychological/Baby and Relational/Spouse-Partner subscale in the maternal quality of life index (p > 0.05). Exercise interventions delivered in a real-time videoconferencing platform are effective at improving the inter-recti distance, trunk stability, and quality of life in postpartum women and may be an alternate to face-to-face intervention.

Diastasis Recti Abdominis Rehabilitation in the Postpartum Period: A Scoping Review of Current Clinical Practice

“…2 ). Although most samples had ultrasound-measured [ 12 , 21 – 23 , 30 – 34 , 36 , 37 , 41 , 43 , 46 – 51 ] or caliper-measured [ 29 , 35 , 38 – 40 , 42 – 45 , 52 ] IRDs between 2.5 and 5 cm, two studies [ 43 , 47 ] encompassed IRDs <2.5 cm, whereas one case series [ 52 ] included women with IRDs >7 cm. However, 7 studies [ 21 , 23 , 32 , 34 , 37 , 45 , 48 ] included postpartum women with combined normal and borderline IRD, according to established classification systems [ 1 ].…”

“…In clinical trials, the IRD was assessed under various conditions, including rest [ 23 , 33 , 37 , 47 , 48 ], head-lift [ 35 , 38 , 52 ], curl-up maneuver [ 29 , 39 , 40 , 42 – 44 ], or combinations [ 21 , 45 , 46 ]. Observational studies also utilized combinations of rest and head-lift/curl-up maneuvers [ 30 , 32 , 49 ] with additional conditions, such as TrA [ 12 , 50 , 51 ] and PFM contractions [ 31 , 36 ], sit-ups [ 38 ], leg raise or side planks [ 41 ], and abdominal hypopressive exercises (AHEs) [ 22 ].…”

“…Time postpartum varied broadly (Fig. 3 ), including women who were between 6 h and 6 months postpartum [ 21 , 23 , 29 , 33 , 39 , 40 , 42 , 48 ], less than 2 days postpartum [ 40 , 42 ], less than 4 months postpartum [ 23 , 33 ], between 1 week and 6 months postpartum [ 21 , 29 , 39 , 48 ], between 2 and 8 months postpartum [ 34 , 44 , 46 ], over 6 months postpartum [ 45 , 47 , 52 ], whereas two studies [ 32 , 43 ] enrolled women at 3 months to 3 years postpartum.

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“…Exercise program duration varied in most studies between 6 and 12 weeks, except for one study [ 40 ], which applied two exercise sessions during the first 24 h postpartum (Appendix 2 ). Exercise frequency ranged from once [ 34 , 35 , 37 , 48 ], twice [ 22 , 47 ], or three times weekly [ 29 , 33 , 39 , 42 – 46 , 52 ]. Twelve studies utilized home exercise programs; 8 recommending daily exercise sessions [ 23 , 32 – 35 , 37 , 42 , 44 ], 2 [ 22 , 43 ] recommending two or three times per week, and 2 [ 46 , 47 ] recommending regular exercise (as often as possible), without additional specifications.…”

The Effects of Conservative Interventions for treating Diastasis Recti Abdominis in Postpartum Women: a Review with Meta-analysis

“…In both groups, it was recommended that the exercise programs are implemented as often as possible. The IRD decreased from 1.99 ± 0.26 cm to 1.37 ± 0.40 cm ( p < 0.001) in the online group and from 1.92 ± 0.30 cm to 1.18 ± 0.30 cm in the offline group ( p < 0.001), with no differences observed between the groups ( p > 0.05) [ 38 ].…”