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Assessment of Abdominal Muscle Thickness in Postpartum Women Who Have Undergone Cesarean Delivery as Compared With Vaginal Births

A Pilot Study

Brizzolara, Kelli J. PT, PhD, OCS1; Wang-Price, Sharon PT, PhD, OCS, COMT, FAAOMPT1; Zafereo, Jason PT, PhD, OCS, FAAOMPT2

Journal of Women’s Health Physical Therapy: January/March 2019 - Volume 43 - Issue 1 - p 22–27
doi: 10.1097/JWH.0000000000000113
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Background: Insufficient stability of the lumbopelvic region has been reported as an underlying cause of lumbopelvic pain in postpartum women. Women early postpartum have been shown to have decreased ability to contract the deep abdominal muscles; however, differentiation has not been made between women who deliver via cesarean delivery versus those who have vaginal births.

Objectives: To compare deep abdominal muscle performance in women who delivered vaginally versus those who delivered via cesarean delivery. The secondary purpose was to determine the reliability of the testing protocol using ultrasound imaging.

Study Design: Case-control design.

Methods: Twenty postpartum women (10 vaginal births and 10 cesarean delivery births) who had given birth within the past 12 months completed the study. Muscle thickness of the transverse abdominis (TrA) and internal oblique abdominis (IO) muscles was measured using ultrasound imaging while the participant performed the abdominal drawing-in maneuver (ADIM). Percent change of muscle thickness was used for statistical analysis as follows: Percent Change = [(Contracted–Rest)/(Rest)] × 100%.

Results: There was no significant difference between groups for the percent change of muscle thickness for the TrA (P = .53) or IO group (P = .80). Interrater reliability was excellent, with intraclass correlation coefficient values of 0.97 for both the TrA and IO groups, respectively.

Conclusion: The results showed no differences in the percent change of deep abdominal muscle thickness during ADIM between women who delivered vaginally and those who delivered via cesarean delivery, indicating that the cesarean delivery surgical procedure may not further decrease abdominal muscle performance.

1School of Physical Therapy, T. Boone Pickens Institute of Health Sciences-Dallas, Texas Woman's University.

2Department of Physical Therapy, School of Health Professions, The University of Texas Southwestern Medical Center, Dallas.

The authors report no conflict of interest.

Copyright © 2019 by the Section on Women's Health, American Physical Therapy Association.
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