eISSN: 1734-4948
ISSN: 0860-6161
Advances in Rehabilitation / Postępy Rehabilitacji
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SCImago Journal & Country Rank
3/2018
 
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abstract:
Original paper

Physiotherapy in women with diastasis of the rectus abdominis muscles

Patrycja Żaneta Bobowik, Aneta Dąbek

Advances in Rehabilitation/Postępy Rehabilitacji (3), 11 – 17, 2018
Online publish date: 2018/12/31
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Background
Diastasis of the rectus abdominis muscles (DRAM) is the separation of the two rectus abdominis muscles more than 2 cm wide. It often arises as a result of android obesity, dysfunctional abdominal cramp and pregnancy. Untreated diastasis may lead to dangerous heath consequences such as.: abdominal hernia, lower back pain or disorders in pelvis’s area. The aim of this study was to determinate the effectiveness of novel physiotherapeutic program in women with diastasis of the rectus abdominis muscles.

Material and methods
The study was conducted on a group of 40 women between 20-45 years old (mean 32,32+5,9 year). They all were qualified in obstetric ward of Szpital Bielański in Warsaw. All of them were in the postpartum between 0-3 days after labor and have DRAM greater than 2 cm (measured by palpation on the umbilicus height, 4,5 cm above and below umbilicus). In research group (included 20 women) applied novel physiotherapeutic program aimed at reduction of DRAM. In controlled group (20 women) there was no therapy but only observation of spontaneous reduction of diastasis. The study took 6 weeks.

Results
Data analysis had shown 95% effectiveness of novel physiotherapeutic program. Chi-square test has confirmed the difference in DRAM size in both groups (p<0,0001). A statistically significant correlation was demonstrated between width of diastasis and growth of the mother’s weight gain in pregnancy, waist-to-hip ratio, BMI, number of delivery and mother’s physical activity before and during pregnancy (p<0,05). There wasn’t clear correlation between width of diastasis and mother’s age or infant’s mass (p>0,05).

Conclusions
It seems that spontaneous reduction of diastasis of the rectus abdominis muscles is very rare. New physiotherapeutic program is an effective method in DRAM’s reduction. The research should be continued in larger group of women and after effectiveness confirmation, program should be introduced in obstetric wards.

keywords:

diastasis rectus abdominis, puerperium, postpartum, physiotherapy, kinesiotaping

references:
Acharry N, Krishnan KR. Abdominal exercise with bracing. A therapeutic efficacy in reducing diastasis-recti among postpartal females. IJPR. 2015;2(3):999-1005.
Benjamin DR, van the Water AT, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods. Physiotherapy. 2014;100(1):1-8.
Volkan T, Cagdas C, Esengul T, Umit K. Prevalance of diastasis recti abdominis in the population of young multiparous adults in Turkey. Ginekol Pol. 2011;82:817-21.
Marshall A: Diastasis Recti: An Overview https://bootcampmilitaryfitnessinstitute.com/injury/diastasis-recti-an-overview/ (dostęp 11.12.2017r.)
Mottola M, Giroux I, Gratton R. Nutrition and exercises prevent excess weight gain in overweigh pregnant women. J Med Sci Sports Exer. 2010;42:265-72.
Gniewek T, Gryckiewicz S, Hadała M. Rola mięśnia poprzecznego brzucha w treningu stabilizacji na podstawie aktualnej ewidencji naukowej. Prakt Fizjoter Rehabi. 2013;37:4-15.
Senderek T, Breitenbach S, Hałas I. Kinesio taping nowe możliwości fizjoterapii kobiet w czasie ciąży. Fizjoter Pol. 2005;5(2):266-71.
Sałdowska D, Serwatka E, Zarotyński D. Kinesio taping kobiet w ciąży. Prakt Fizjoter Rehabi. 2013;36:24-9.
Sancho MF, Pascoal AG, Mota P, Bø K. Abdominal exercise affect inter-rectus distance in postpartum women: a two-dimensional ultrasound study. Physiotherapy. 2015;101(3):286-91.
Kmieć-Nowakowska J. Diagnozowanie i planowanie procesu terapeutycznego u kobiet z rozejściem mięśnie prostych brzucha w ciąży i po porodzie. Prakt Fizjoter Rehabi. 2017:32-7.
Pascoal AG, Dionisio S, Cordeiro F, Mota P. Inter-rectus distance in postpartum women can be reduced by isometric contraction of the abdominal muscles: a preliminary case–control study. Physiotherapy. 2014 Dec;100(1):344-8.
Torbe D, Torbe A, Ćwiek D. Aktywność fizyczna zalecana we wczesnym połogu. Pomeranian J Life Sci. 2016;62(3): 53-6.
van de Water AT, Benjamin DR. Measurement methods to assess diastasis of the rectus abdominis muscle (DRAM): A systematic review of their measurement properties and meta-analytic reliability generalisation. Man Ther. 2016 Feb;21:41-53.
Gilleard WL, Brown JM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. Phys Ther. 1996 Jul;76(7):750-62.
Fernandes da Mota PG, Pascoal AG, Carita AI, Bø K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum and relationship with lumbo-pelvic pain. Man Ther. 2015 Feb;20:200-5.
Litos K. Progressive Therapeutic Exercise Program for Successful Treatment of a Postpartum Woman With a Severe Diastasis Recti Abdominis. J Womens Health Phys Ther. 2014 May;38(2):58-70.
Mota P, Pascoal AG, Carita AI, Bø K. The immediate Effects on Inter-rectus Distance of Abdominal Cruncand Drawing-in Exercise During Pregnancy and the Postpartum Period. J Orthop Sports Phys Ther. 2015 Oct;45(10):781-7.
Emanuelsson P. Alternatives in the treatment of abdominal rectus muscle diastasis. An evaluation. Karolinska Institutet, Sztokholm; 2014.
Kuryłowicz W.: Cylinder mięśniowy – stabilizacja lokalna http://www.trenerindywidualny.pl/2014-05-05-12-58 36/artykuly-trening-po-kontuzji/1550-cylinder-miesniowy-stabilizacja-lokalna.html (dostęp 14.02.2018r.)
Kwolek A, Rzucidło S, Zwolińska J, Pop T, Janeczko J, Przygoda Ł. Leczenie zachowawcze wysiłkowego nietrzymania moczu u kobiet. Przegląd Medyczny Uniwersytetu Rzeszowskiego. 2006;3:227–33.
Torbe D, Torbe A, Ćwiek D. Aktywność fizyczna kobiet w ciąży o fizjologicznym przebiegu. Nowa Med. 2013;4:174-9.
Rajkowska N, Szumilewicz A. Prenatalne ćwiczenia mięśni brzucha w świadomości kobiet ciężarnych i młodych matek. Rocznik Naukowy t. XXIV, AWFiS w Gdańsku. 2014.
Ng Hung Shin PB, Osmotherly PG, Chiarelli P. Pre-activation of transversus abdominis protects the rectus abdominis diastasis of post-partum women doing a head lift. Aviable at: Abstracts from APA Conference Week 1–5, Sydney Convention Centre, Australia; Continence and Women’s Health Physiotherapy Australia. 2009;6
Opala- Berdzik A, Dąbrowski S. Postępowanie fizjoterapeutyczne w przypadku rozstępu mięśni prostych brzucha u kobiet w ciąży i po porodzie. Fizjoterapia. 2009;17(4):67-70.
Stupnicki R. Pomiary i normy w antropometrii. Zeszyty Naukowe WSKFiT 11. 2016;13-20.
Dąbrowiecki S.: Rozstęp mięśni prostych brzucha. http://www.przepukliny.com.pl/co-to-jest-przepuklina/rozstep-miesni-prostych-brzucha.html#rozjescie_men (dostęp 04.11.2017)
Sharma G. Postnatal Exercise Can Reverse Diastasis Recti. Obstet Gynecol. 2016;123(5):171.










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