Diastasis Recti
Conditions
Keywords
Diastasis recti abdominis, inter-recti distance, corrective exercises, plank exercises, postpartum rehabilitation, pain, abdominal strength
Brief summary
This study will be randomized clinical trial and will be conducted in Services Hospital and poly clinics. The total duration of treatment will be 12 weeks. Non-probability convenience sampling technique will be used and 56 participants will be recruited in study after randomization. The participants are randomly assigned to one of two groups: Group A performs corrective exercises focused on deep core engagement, while Group B performs plank exercises aimed at overall abdominal activation. Each group follows their respective regimen three times per week for 12 weeks. Baseline EMS and pelvic floor exercises are conducted for all participants to ensure core stability before the interventions begin. Outcome measures, including manual muscle testing (MMT) for strength, and the Numerical Pain Rating Scale (NPRS) for pain, are recorded both before and after the 12-week intervention. After data collection data will be analyzed by using SPSS version 25.
Interventions
OTHERcorrective exercises
restoration of trunk stability, and reduction of IRD through improved tensioning of the linea alba. During weeks 1-4, the program emphasized low-load activation, including transversus abdominis (TrA) drawing-in activation, posterior pelvic tilting, and modified heel slides performed with strict abdominal control. In weeks 5-8, progression was achieved through increased hold times, higher repetitions, slower tempo, and the gradual introduction of light resistance or functional integration cues where tolerated. In weeks 9-12, participants progressed toward functional core integration and advanced control exercises such as dead bug variations,
OTHERPlank Exercise
In weeks 1-4, the program began with modified plank positions using knee-and-elbow support and modified side planks, with short hold durations and adequate rest intervals. During weeks 5-8, hold times were progressively increased, and participants were introduced to controlled plank variations such as weight-shifts or arm reach tasks depending on tolerance and maintenance of neutral spine control. In weeks 9-12, progression was aimed toward longer holds and more advanced stabilization tasks, including leg lifts in plank and progression toward full plank positions
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
25 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* If IRD is greater than 4cm and above * Postpartum females * Three months to three years postpartum with presence of diastasis rectus abdominis * Vaginal delivery * Multiparous * Pain greater than 6 on NPRS
Exclusion criteria
* Subjects with any heart condition, respiratory condition * Any pelvic or abdominal surgery * Any neurological disease eg preeclampsia, epilepsy * Trauma to bowel or bladder * Prior history of physical therapy treatment for pelvic floor issues * Postpartum depression
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| NPRS | 12th week | The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain. The NPRS is a widely used patient reported outcome scale.27-29 The ordinal 11-point NPRS (0-no pain, 10-most intense pain) is the most commonly used version which has good test-retest reliability (r=.79-.96) in individuals with chronic pain and musculoskeletal pathology. |
| • MMT | 12th week | MMT is the most commonly used method for documenting impairments in muscle strength. Manual muscle testing is used in rehabilitation and recovery to evaluate contractile units, including muscles and tendons, and their ability to generate forces. Reliability of strength MMT grade of lower extremity is 66-0.90. There are six grades of MMT i.e. Grade 5 (Normal), Grade 4 (Good), Grade 3+ (Fair), Grade 2+ (Poor), Grade 1 (Trace) and Grade 0 (Zero) |
| inter-recti distance | 12th week | The subjects were in supine resting position with the knees bent at 90° and feet resting on the plinth, arms alongside the body. After instruction in how to perform an abdominal crunch the subjects were asked to raise the head and shoulders upwards until the shoulder blades cleared the table. One physiotherapist placed the fingers vertically on the subject's Linea Alba in a way that fingers widths could fit the distance between the internal borders of the two rectus abdominis muscles. Using the center of the umbilicus as a reference, measurements were taken in two previously marked locations: one being 2 cm above the umbilicus and the other being 2 cm below the umbilicus. |
| Oswestry Disability Index | 12th week | The Oswestry Disability Index (ODI) is defined as a validated metric that assesses a patient's perceived level of disability through a 10-question assessment, yielding a numerical score from 0 to 100, where higher scores indicate greater disability |
Countries
Pakistan
Contacts
CONTACTimran amjad, PhD
PRINCIPAL_INVESTIGATORadeela arif, t-DPT
Riphah International University
Outcome results
None listed