Diastasis Recti
Conditions
Keywords
Female, Exercise, Exercise therapy, Pelvic floor, Postpartum period, Muscle strength.
Brief summary
To compare the effects of hypopressive exercises and split tummy (transverse abdominal activation-based) exercises on inter-recti distance (IRD), pelvic floor muscle strength and function, and overall quality of life improvements in postpartum women with diastasis recti. This study will be randomized clinical trial and will be conducted in Hameed Latif Hospital Lahore and Civil Hospital Sukkur. The total duration of treatment will be 8 week. Non-probability convenience sampling technique will be used and 50 participants will be recruited in study after randomization. The subjects will be divided into two groups. Group A will receive hypopressive exercise with baseline treatment abdominal binding. Group B will receive baseline treatment with split tummy exercises.
Detailed description
Postpartum diastasis recti abdominis (DRA) is a common condition affecting women after childbirth, characterized by the separation of the rectus abdominis muscles along the linea alba. This condition can lead to core instability, pelvic floor dysfunction, back pain, and a negative impact on daily function and quality of life. Rehabilitation through exercise is considered a primary non-surgical treatment. However, the most effective approach to improving both physical parameters and overall lifestyle remains under investigation. To compare the effects of hypopressive exercises and split tummy (transverse abdominal activation-based) exercises on inter-recti distance (IRD), pelvic floor muscle strength and function, and overall quality of life improvements in postpartum women with diastasis recti. This study will be randomized clinical trial and will be conducted in Hameed Latif Hospital Lahore and Civil Hospital Sukkur. The total duration of treatment will be 8 week. Non-probability convenience sampling technique will be used and 50 participants will be recruited in study after randomization. The subjects will be divided into two groups. Group A will receive hypopressive exercise with baseline treatment abdominal binding. Group B will receive baseline treatment with split tummy exercises. The tools that will be used are digital vernier scale use for inter recti distance, oswestry disability index (ODI), Oxford Grading scale system use for strength and function of pelvic floor muscles and quality of life questionnaire. Data will be analyzed using SPSS version 21. With the significant P value \< 0.05.
Interventions
For participants in Group A, series of postural and breathing-based sequences will be given. Base-line is abdominal binding I will performed hypopressive exercises in various positions (lying, sitting, leaning forward, standing and quadruped) to improve breath control, abdominal contraction and pelvic floor engagement. Each session began with focused breathing, full increasing based on tolerance. Exercises were repeated in different postures to assess endurance in each, as individual holding each contraction 5 seconds and relax for 10 seconds capacity varied by position. Participants engaged in these exercises for 20 minutes, 3 times per week, over a 8 week period, with moderate to high intensity based on breath-hold duration and postural demand.
OTHERsplit tummy exercises
Base-line abdominal binding I will perform isometric exercises (1) Modified plank hold (2) Pelvic tilts (3) Transverse abdominis engagement. For modified plank hold in this position participants with their knees on the ground instead of toes. Engage core muscles and hold for 30 to 60 seconds. For pelvic tilts participants lie on back with knees bent and feet flat on the floor. Tilt the pelvic upwards and then back down again, repeating the motion in a slow and controlled manner. Hold for 30 to 60 seconds. For transverse abdominis engagement participants lies on back with knees bent and feet flat on the floor. Engage transverse abdominis muscle and drawing belly button towards spine. Hold for 30 to 60 seconds. 3 times in a week involving at least three sets of 10 repetitions each. To improved core strength and stability, increased muscle endurance and isometric exercises can be low-impact, making them suitable for individuals with diastasis recti.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
FEMALE
Age
24 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Age: 24 to 40years * Weight: 50 to 70kg * Height: 4.5 to 6ft * BMI: Both underweight and overweight/ obese individuals can experience DRA. * Parity: Multiparous * Mode of delivery: vaginal delivery in split tummy. * Subjects who gave vaginal birth with or without episiotomy in multiparous women in hypopressive.
Exclusion criteria
* Undergoing a severe illness * Uncompleted inter-rectus distance (IRD) records * Have a history of pelvic floor dysfunction * Primiparous, polyhydramnios, uterine fibroids during pregnancy, previous abdominal, surgery caesarean delivery * Subjects with untreated high blood pressure, cardiovascular illness, hernia, pregnant and underwent any recent surgeries.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Digital Vernier Calliper | 8 weeks | The Oswestry Disability Index (ODI) and inter-recti distance were measured at the start (baseline) and again at the 8th week. A digital vernier caliper was used to assess the inter-recti distance at three specific locations: directly at the umbilicus, 4.5 cm above, and 4.5 cm below it. The ODI evaluates functional disability based on ten factors: pain intensity, ability to maintain personal hygiene, lifting, work, standing, sitting, sleeping, sexual activity, social interaction, and travel. ODI scores range as follows: 0-20% indicates minimal disability, 21-40% suggests moderate disability, 41-60% reflects severe disability, 61-80% indicates significant functional limitation, and 81-100% implies the patient is confined to bed. |
| Quality of life questionnaire | 8 weeks | The SF-36 is regarded as a valid and reliable tool with strong discriminatory and convergent validity that allows it to differentiate across respondent groups according to age, gender, and socioeconomic position. It has eight sub scales and 36 items. (1) Physical functioning (PF), (2) Role-physical (RP), (3) Bodily pain (BP), (4) General health (GH), (5) Vitality (VT), (6) Social functioning (SF), (7) Role-emotional (RE), and (8) Emotional wellbeing (EW). Higher ratings on each subscale, which range from 0 to 100, indicate better conditions . |
| Pelvic floor strength and function | 8 weeks | Digital assessment of PFM strength using the Oxford Grading Scale system will distributed as follows: weak (n = 1), moderate (n = 6), good (n = 10) and strong (n = 26)(16). The reliability of oxford grading scale system is 0.53. |
Countries
Pakistan
Contacts
CONTACTImran Amjad, PhD
PRINCIPAL_INVESTIGATORHafiza Iqra Rubab, MSWHPT
Riphah International University
Outcome results
None listed