International Journal of Physiotherapy and Research



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Type of Article : Original Research

Year: 2015 | Volume 3 | Issue 2 | Page No. 999-1005

Date of Publication: 11-04-2015

DOI: 10.16965/ijpr.2015.122

ABDOMINAL EXERCISE WITH BRACING, A THERAPEUTIC EFFICACY IN REDUCING DIASTASIS-RECTI AMONG POSTPARTAL FEMALES  

Nisha Acharry 1, Rahul Krishnan Kutty *2.  

*1 Clinical Physiotherapist, Department of Physiotherapy, College of Health sciences, Mekelle University, Ethiopia.
*2 Lecturer in Physiotherapy, Department of Physiotherapy, College of Health sciences, Mekelle University, Ethiopia.

Corresponding author: Rahul Krishnan Kutty PhD, PT. Lecturer Department of Physiotherapy, College of Health sciences, Mekelle University, Ethiopia.
E-Mail:
physioraul@gmail.com

Abstract:

Background Diastasis recti abdominis (DRA) has been defined as an impairment characterized by the separation of the two rectus abdominis muscles along the linea alba , Diastasis of the rectus abdominis muscle (DRAM) is common during and after pregnancy, and has been related to lumbo-pelvic instability and pelvic floor weakness. Women with DRAM are commonly referred to physiotherapists for non surgical management, but very few found to be effective. Objectives To determine if the  effectiveness  of  Abdominal exercise with bracing  in  reducing   the  diastasis  recti  among postpartum females.
Methodology: IP&OPD patients of Godavari hospital, Jalgaon for a period of 4 weeks. For this descriptive study a cross-sectional study design was incorporated. A number of (n=30) female patients within 1 month after delivery with Diastasis recti were selected. Each patient was screened, initially by using simple selection proforma relevant to the inclusion and exclusion criteria.
Results: A total (n=30) subjects were included in the study, these 30 subjects all are Females and one month and more after child birth. The subjects included in this study with an age from minimal 23 years to 34 years old.  Number of off springs which is another variable used, was listed as 1(Minimum) and 4(Maximum) children’s. In this study a 26.6% of female are primiparous and 56.7% of them are multiparous. The collected information (data) was tabulated and analyzed by using appropriate statistical analysis tools. 30 Female subjects having mean age 28.8(SD=3.23) in which both primiparous and multiparous women having diastasis recti within 1 month postpartum.  Diastasis recti pretest was found to be 3.5(SD= 0.5085) Diastasis recti posttest was found to be 2.5(SD=0.5074) t value=29.00 and P value found to be less than 0.001 which is highly significant.
Conclusion: Based on the available evidence and quality of this evidence, after the exercise regimen and bracing the Diastasis recti muscle separation by finger palpation was found to be reduced. Hence, it can be interpreted that with non-surgical interventions (Physical Therapy) can prevent or reduce DRAM in the postpartum.
KEY WORDS: Physiotherapy, Diastasis Recti, Abdominal Exercise and Bracing, Postpartum Female, Rehabilitation Of Diastasis Recti.

References

  1. Axer H, Keyserlingk DG, Prescher A. Collagen fibers in linea alba and rectus sheaths. I. General scheme and morphological aspects. J Surg Res 2001 Mar;96(1): 127-34.
  2. Boissonnault JS, Blaschak MJ. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther 1988 Jul;68(7):1082-6. 
  3. Gilleard WL, Brown JMM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. Physical therapy. Am Phys Ther Assoc 1996 Jul 1;76(7):750-62
  4. Hsia M, Jones S. Natural resolution of rectus abdominis diastasis. Twosingle case studies. Aust J Physiother 2000;46:301–7.
  5. Rath AM, Attali P, Dumas JL, Goldlust D, Zhang J, Chevrel JP. Theabdominal linea alba: an anatomo-radiologic and biomechanical study.Surg Radiol Anat 1996;18:281–8.
  6. Chiarello CM, Falzone LA, McCaslin KE, Patel MN, Ulery KR.The effects of an exercise program on diastasis recti abdomi-nis in pregnant women. J Womens Health Phys Ther 2005;29:11–6 [corrected, published erratum appears in J Womens Health PhysTher 2005;29:76].
  7. Lo T, Candido G, Janssen P. Diastasis of the recti abdominis inpregnancy: risk factors and treatment. Physiother Can 1999;51:32–6,44.]
  8. Coldron Y, Stokes M, Newham D, Cook K. Postpartum characteris-tics of rectus abdominis on ultrasound imaging. Man Ther 2008;13:112–21.
  9. Hanneford R, Tozer J. An investigation of the incidence, degree andpossible predisposing factors of the rectus diastasis in the immedi-ate post-partum period. J Nat Obstet Gynaecol Special Group AustPhysiother Assoc 1985;4:29–32.
  10. Candido G, Lo T, Janssen P. Risk factors for diastasis of therecti abdominis. J Assoc Chart Physiother Womens Health 2005;97:49–54.
  11. Bursch SG. Interrater reliability of diastasis recti abdominis measure-ment. Phys Ther 1987;67:1077–9.
  12. Richardson CA, Jull G, Hodges PW, Hides JA. Backpain and lum-bopelvic stabilisation: the case for the local muscle system. In:Richardson CA, Jull G, Hodges PW, Hides JA, editors. Therapeuticexercise for spinal segmental stabilisation in low back pain: sci-entific basis and clinical approach. London: Churchill Livingstone;1999.
  13. Lee DG, Lee LJ, McLaughlin L. Stability, continence and breathing:the role of fascia following pregnancy and delivery. J Bodywork MoveTher 2008;12:333–48.
  14. Fast A, Weiss L, Ducommun EJ, Medina E, Butler JG. Low-back painin pregnancy. Abdominal muscles, sit-up performance, and back pain.Spine (Phila Pa 1976) 1990;15:28–30.
  15. Liaw L-J, Hsu M-J, Liao C-F, Liu M-F, Hsu A-T. The rela-tionships between inter-recti distance measured by ultrasoundimaging and abdominal muscle function in postpartum women:a 6-month follow-up study. J Orthop Sports Phys Ther 2011;41:435–43.
  16. Noble E: Essential Exercises for the Childbearing Year, ed 2. Boston, MA, Houghton Mifflin Co, 1982, pp 8, 58-6.
  17. Culbertson C: Surgery of the Female Pelvis: Gynecological and Obstetrical Monographs. New York, NY, Appleton & Co, 1931, p 211.
  18. Kendall FP, McCreary EK: Muscles: Testing and Function, ed 3. Baltimore, MD, Williams & Wilkins, 1983, p 214.
  19. Porterfield JA: Dynamic stabilization of the trunk. Journal of Orthopaedic and Sports Physical Therapy 6:271-277, 1985.
  20. Elbaz JS, Flageul G (translated from French by W. T. Keavy): Plastic Surgery of the Abdomen. New York, NY, Masson Publishing USA Inc,1979, p 6.
  21. Spitznagle TM, Leong FC, van Dillen LR 2007 Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecology J 18:3.
  22. Mantle J, Haslam J, Barton S, Cardozo L. Physiotherapy in obstetrics and gynaecology.2004.
  23. Boxer S, Jones S. Intra-rater reliability of rectus abdominis diastasis measurement using dial calipers. Aust J Physiother 1997;43(2):109-14.
  24. Mota P, Pascoal AG, Sancho F, Bø K. Testeretest and intrarater reliability of 2- dimensional ultrasound measurements of distance between rectus abdominis in women. J Orthop Sports Phys Ther 2012 Nov;42(11):940-6.
  25. Benjamin DR, van de Water ATM, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy 2014 Mar;100(1):1-8.
  26. Sapsford R, Bullock-Saxton J, Markwell S. Women’s health: a text-book for physiotherapists. 1st ed. London: WB Saunders CompanyLtd; 1998.
  27.  Opala-Berdzik A, Dabrowski S. Physiotherapy in diastasis of the rec-tus muscles of abdomen in women during pregnancy and postpartum.Fizjoterapia 2009;17:67–70 [in Polish].
  28. Keeler J, Albrecht M, Eberhardt L, Horn L, Donnelly C, Lowe D. Dias-tasis recti abdominis: a survey of women’s health specialists for currentphysical therapy clinical practice for postpartum women. J Women’sHealth Phys Ther 2012;36:131–42.
  29. Sheppard S. Case study. The role of transversus abdominus in postpartum correction of gross divarication recti. Man Ther 1996;1:214–6.
  30. Jill Schiff Boissonnault and Mary Jo Blaschak , Childbearing Year Incidence of Diastasis Recti Abdominis During the Childbearing Year, phys ther. 1988; 68:1082-1086.

 

Nisha Acharry, Rahul Krishnan Kutty. ABDOMINAL EXERCISE WITH BRACING, A THERAPEUTIC EFFICACY IN REDUCING DIASTASIS-RECTI AMONG POSTPARTAL FEMALES. Int J Physiother Res 2015;3(2):999-1005. DOI: 10.16965/ijpr.2015.122

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