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Noninvasive Treatment of Postpartum Diastasis Recti Abdominis

A Pilot Study

Tuttle, Lori J. PT, PhD1; Fasching, Jennifer SPT1; Keller, Allison SPT1; Patel, Milan SPT1; Saville, Chelsea SPT1; Schlaff, Rose SPT1; Walker, Alicia SPT1; Mason, Maureen PT, WCS2; Gombatto, Sara P. PT, PhD1

Journal of Women’s Health Physical Therapy: May/August 2018 - Volume 42 - Issue 2 - p 65–75
doi: 10.1097/JWH.0000000000000101
Research Reports

Objective: To examine the effectiveness of physical therapy intervention for treating diastasis recti abdominis (DRA) in the postpartum population, with emphasis on transverse abdominis (TRA) exercise and kinesiotaping.

Study Design: Pilot randomized controlled trial.

Background: DRA may be linked to lumbopelvic and gynecological health problems, and there is limited evidence describing effective noninvasive treatments of DRA in postpartum women.

Methods and Measures: Thirty women, 6 to 12 weeks postpartum with a palpable separation of the rectus abdominis muscles (32.03 ± 4.33 years old; number of births = 2.30 ± 1.34), were randomly assigned to TRA exercise intervention (n = 10), kinesiotaping intervention (n = 8), TRA exercise and kinesiotaping combination intervention (n = 5), or control (n = 7). The primary outcome was inter-recti distance (IRD), measured via ultrasound imaging. Secondary outcomes of low back pain and pelvic floor dysfunction were measured via validated questionnaires (Pelvic Floor Distress Inventory [PFDI-20] and Roland-Morris Disability Questionnaire). Data are presented as means ± standard deviation.

Results: The largest changes in IRD were observed for the TRA exercise–only and TRA exercise + taping groups. There was no statistical difference in IRD change between the TRA exercise–only and TRA exercise + taping groups. Both groups with TRA exercise components were statistically different from the taping-only group and the control group in IRD change.

Conclusions: Based on our preliminary data, exercise targeting the TRA may be an effective treatment method for reducing IRD. Further studies that include a larger patient population, particularly those with low back pain and pelvic floor dysfunction, are needed to replicate these findings and to establish a standardized exercise protocol for DRA.

1Doctor of Physical Therapy Program, San Diego State University, San Diego, California.

2Function Smart Physical Therapy, San Diego, California.

Funding for this study was provided by the University Grants Program at San Diego State University.

The authors declare no conflicts of interest.

Copyright © 2018 by the Section on Women's Health, American Physical Therapy Association.
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