Effect of exercise on the inter-rectus distance in pregnant women with diastasis recti abdominis: an experimental longitudinal study.

ABSTRACT

OBJECTIVE: To investigate the effect of acute contraction of the pelvic floor muscles (PFM) and abdominal exercises on the inter-rectus distance (IRD) compared to resting values, and differences between gestation weeks 27 and 37, in pregnant women with diastasis recti abdominis (DRA). DESIGN: Experimental longitudinal design. SETTING: Physiotherapy clinic, primary health care. PARTICIPANTS: Thirty-eight pregnant women with DRA ≥ 2.8 cm. INTERVENTIONS: Two-dimensional ultrasound images of IRD 2 cm above and below the umbilicus were taken at rest and during PFM and abdominal exercises at gestation week 27 and 37. Repeated measures analyses of variance (ANOVAs) with post hoc tests was performed for each exercise for both locations and timepoints. MAIN OUTCOME MEASURES: Change in IRD. RESULTS: There was a mean increase of the IRD from rest during a PFM contraction (2 mm, 95% CI 2, 3), drawing-in (4 mm, 95% CI 3, 5) and a combination of these (5 mm, 95% CI 4, 6) There was a mean decrease of the IRD from rest during the headlift (-3 mm, 95% CI -4, -2), the curl-up (-3 mm, 95% CI -4, -2) and the diagonal curl up (-4 mm, 95% CI -5, -3). Effect of time from gestation week 27-37 was a mean increase of 8 mm (95% CI 6, 9). CONCLUSION: Pelvic floor and drawing-in exercise increased the IRD, whilst headlift, curl up and diagonal curl up decreased the IRD in pregnant women with DRA at gestation week 27 and 37. CONTRIBUTION OF THE PAPER.