Exploring the relationship between lower limb strength, strength asymmetries, and curvilinear sprint performance: Findings from a pilot study.

Team sports involve various sprinting actions, including curvilinear sprints, yet their neuromuscular factors have been understudied. The aim of this cross-sectional study was to investigate the relationship between lower limb muscle strength, strength asymmetries, linear sprint and curvilinear sprint performance. At two visits 12 male (age: 24.8 ± 4.7 years, height: 1.82 ± 0.06 m, body mass: 80 ± 6.58 kg) and 6 female (age: 20.8 ± 1.33 years, body height: 1.60 ± 0.02 m, body mass: 55.3 ± 2.88 kg) student-athletes completed isometric strength measurements of the knee flexors (KF), knee extensors (KE), hip abductors (HABD), hip adductors (HADD), as well as linear sprint and curvilinear sprint to the right and left. Sprint split times over 30 m (t30) were measured and curvilinear sprint split time deficits (t30deficit) and inter-limb strength asymmetries were calculated. Very large negative correlations were observed between HADD and HABD strength on one side and t30 of curvilinear sprint to the left (r = -0.75 and -0.71; p < 0.001) and right (ρ = -0.81 and -0.70; p < 0.001) on the other. The regression model consisting of HADD, HABD, and KF explained 76% and 67% of the variance in left and right curvilinear sprint t30, respectively. Similarly, 59% of the left curvilinear sprint t30deficit variance was explained by the HABD and KF strength. High inter-limb HABD strength symmetry was related to better left and right curvilinear sprint t30 (r = 0.71 and ρ = 0.75, p < 0.001). These results highlight the pivotal role of hip strength for curvilinear sprint speed, and emphasize the need of symmetrical HABD muscle strength to optimize neuromuscular function during curvilinear sprint.

Is larger eccentric utilization ratio associated with poorer rate of force development in squat jump? An exploratory study.

This exploratory study examines the relationship between the eccentric utilization ratio (EUR) and the rate of force development (RFD) in squat jumps (SJ). EUR, a key metric in sports science, compares performance in countermovement jumps (CMJ) and squat jumps (SJ). The study hypothesizes that a higher EUR is associated with a poorer RFD in SJ. Basketball and soccer players, long-distance runners, alongside physical education students (209 men; age: 23.2 ± 4.95 years and 104 women; age: 22.7 ± 4.42 years) participated. The EUR was calculated from jump height, peak force and peak power. The results indicated a small to moderate but significant negative correlation between EUR based on peak force or peak power and RFD in SJ (r = -.41 and -.27), suggesting that a higher EUR might be linked to a diminished ability to rapidly develop force in SJ. Thus, a higher EUR may not indicate superior athletic performance.

Responsiveness of Isokinetic Dynamometry in Patients with Osteoarthritis after Knee and Hip Arthroplasty: A Prospective Repeated-Measures Cohort Study.

Functional assessments are crucial for the evaluation of rehabilitation after total knee (TKA) and hip (THA) arthroplasty. Muscle strength, a key determinant of physical function (PF), is often measured with isokinetic dynamometry (ID), which is considered the gold standard. However, studies lack evaluations of responsiveness-the ability to detect changes over time. This study aims to determine the responsiveness of ID in measuring PF in TKA and THA rehabilitation-is muscle strength a valid indicator for assessing improvement in rehabilitation processes? The pre- and post-surgery PF of 20 osteoarthritis patients (age 55-82) was assessed, using ID, performance-based and self-reported measures. Responsiveness was evaluated by comparing the observed relationship of changes in ID and PF scores with the a priori defined expected relationship of change scores. While the performance-based and self-reported measures showed significant improvements post-surgery (Cohen's d [0.42, 1.05] p < 0.05), ID showed no significant differences. Moderate correlations were found between changes in some ID parameters and selected functional tests (r ≈|0.5|, p < 0.05). Responsiveness was solely found for the peak torque of knee extension at 180°/s on the operated side. Responsiveness is an often-overlooked psychometric property of outcome measurements. The findings suggest that ID may not be fully responsive to the construct of PF after TKA and THA, raising questions about its role and usefulness in this context and the need for more appropriate assessment methods.

A patient with bilateral neuralgic amyotrophy and hepatitis E virus infection: an educational communication.

Neuralgic Amyotrophy, a peripheral nervous system disorder, is characterized by severe pain and muscle weakness, which can have a significant impact on patients' quality of life. The exact cause of neuralgic amyotrophy is unknown, but it may be linked to immunopathological mechanisms. Recent research has found an association between neuralgic amyotrophy and hepatitis E virus infection. This communication aims to expand knowledge on the clinical phenotype of patients with neuralgic amyotrophy and hepatitis E virus infection, presenting the case of a 55-year-old man diagnosed with bilateral neuralgic amyotrophy and hepatitis E virus infection.

Effects of device-performed and manual hip traction and vibration therapy in older adults with symptomatic hip osteoarthritis: A randomized single-blind controlled trial.

BACKGROUND: Traction-and-vibration-therapy (TVT) relieves pain in participants with hip osteoarthritis. Hip TVT is usually performed manually by the physiotherapist. OBJECTIVE: A medical device was developed to perform hip-TVT in order to investigate effects on hip disability, pain intensity, recovery of balance and functional mobility in older adults with hip osteoarthritis and also to reduce physiotherapists' workload and help standardize treatment of hip TVT. METHODS: In a block-randomized 3-month controlled trial involving 28 older adult participants with symptomatic primary hip osteoarthritis (SPHOA), one group (n= 10) received device-performed TVT, one (n= 10) manual TVT, and one (n= 8) sham/placebo therapy. Hip disability (Harris Hip Score), pain intensity (visual-analog-scale), recovery of balance and gait (Functional Gait Assessment) and functional mobility (Timed-Up-and-Go-test) were assessed at baseline, after 3 weeks without intervention, and after 3-month intervention. RESULTS: The Device TVT and Manual TVT groups exhibited superior outcomes compared to the Placebo group in terms of hip disability (p= 0.005 and p< 0.001, respectively), pain intensity (p= 0.002 and p< 0.001, respectively), and functional mobility (TUG) (p= 0.012 and p= 0.011, respectively). Furthermore, the recovery of balance and gait (FGA) showed a significant improvement in the Device TVT group when compared to the Placebo group (p= 0.043). The effect sizes ranged from 0.17 to 0.51, indicating moderate to large effects. CONCLUSION: Device-performed-TVT is comparable to manual hip-TVT for reducing pain and improving mobility in older adults with SPHOA, and may be beneficial in terms of reducing physiotherapists' workload and better therapy standardization.

Can lifelong endurance exercise improve ageing through beneficial effects on circadian timing function, muscular performance and health status in men? Protocol for a comparative cross-sectional study.

A well-synchronized circadian system is a manifestation of an individual's health. A gradual weakening of the circadian timing function characterizes aging. Regular exercise has been suggested as a modality to improve many detrimental changes associated with aging. Therefore, we aim to examine the benefits and risks of lifelong endurance exercise on age-dependent changes in the circadian time-keeping function, the performance of the muscular system and health status. The study protocol has a comparative cross-sectional design, including groups of senior (65 to 75 years old, n=16) and young (20-30 years old, n=16) endurance runners and triathletes. Age-matched groups of young and elderly sedentary men are included as controls. The circadian function is evaluated mainly by measurement of urinary 6-sulphatoxymelatonin, a metabolite of the hormone melatonin shown to participate in the modulation of sleep cycles. The 6-sulphatoxymelatonin will be assessed in urine samples collected upon awakening in the morning and in the late evening, as a marker of melatonin production. In addition, sleep/activity rhythms and sleep quality will be measured by wrist actigraphy. Performance of the muscular system will be assessed by examination of muscular strength and quantifying of gene expression in the skeletal muscle tissue samples. Health status and age-induced reduction in immune function are to be analysed via the balance of pro- and anti-inflammatory immune markers in the plasma and skeletal muscle, body composition, bone density and physical fitness.

Effects of adding glucosamine or glucosamine combined with chondroitin to exercise on pain and physical function in adults with knee osteoarthritis: a systematic review and meta-analysis.

It is well known that different types of exercise significantly improve physical function and relieve pain in knee osteoarthritis (KOA) patients. The aim of this study was to investigate the added effects of glucosamine or glucosamine and chondroitin supplementation in combination with an exercise program in the management of KOA. The randomized controlled trials on adding glucosamine (G) or G combined with chondroitin (C) to an exercise program in the treatment of KOA were searched in the PubMed, Cochrane Central Register of Controlled Trials, PEDro, and Web of Science online databases. The Pedro scale tool was used to assess quality of literature. A meta-analysis was performed using the Review Manager 5.4 software. In total, 6 studies (including 297 participants) were included for the final meta-analysis. According to the PEDro scale, the average quality of the studies was rated as good (mean = 8.2 (2)). The results showed that the effect of G, or G and C, in combination with exercise is not significant, as indicated by the assessed knee pain (WOMAC pain: SMD -0.18, 95% CI -0.47 to 0.11, p = 0.23; and VAS pain: SMD -0.34, 95% CI -0.85 to 0.17, p = 0.20) and physical function (SMD -0.13, 95% CI -0.95 to 0.69, p = 0.76). Adding glucosamine alone or a combination of glucosamine and chondroitin to exercise, has no effect on knee pain and physical function compared with exercise alone in KOA patients. Keywords: treatment, dietary supplement, physical activity, older adults.

Are reallocations of time between physical activity, sedentary behaviour and sleep associated with low back pain? A compositional data analysis.

Objectives: The aim of this cross-sectional study was to explore the associations of reallocating time between moderate- to vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), sedentary behaviour (SB) and sleep with occurrence, frequency and intensity of low back pain (LBP) among adults using compositional isotemporal substitution analysis. Methods: A total of 2333 participants from the general adult population completed the Daily Activity Behaviours Questionnaire asking about their time-use composition consisting of sleep, SB, LPA and MVPA, and they self-reported their frequency and intensity of LBP in the past year. Results: Regression analyses adjusted for age, sex, body mass index, smoking, stress, education and socioeconomic status found that the time-use composition is associated with the frequency (p=0.009) and intensity of LBP (p<0.001). Reallocating time from SB or LPA to sleep was associated with lower frequency and intensity of LBP (p<0.05). Reallocating time from MVPA to sleep, SB or LPA and from SB to LPA was associated with a lower intensity of LBP (p<0.05). For example, reallocating 30 min/day from SB to sleep was associated with 5% lower odds (95% CI: 2% to 8%, p=0.001) of experiencing LBP more frequently, and 2% lower LBP intensity (95% CI: 1% to 3%, p<0.001). Conclusion: LBP sufferers may benefit from getting additional sleep and spending more time in LPA, while engaging less in SB and MVPA. These reallocations of time may be meaningful from clinical and public health perspectives.

Comments on: Electromyographic signature of isometric squat in the highest refuge in Europe.

We read with particular interest the study by Rua et al. (Eur J Transl Myol 33 (3) 11637, 2023 doi: 10.4081/ejtm.2023.11637) on the electromyographic (EMG) activity of the quadriceps muscle during squat at high-altitude. It offers interesting insights into how neural factors might alter muscle function during a multi-joint low-intensity motor task with sustained contraction after trekking under hypoxic conditions. However, the methodological processes and procedures used in the study could bias the interpretation of the outcomes. Therefore, we outline the procedural considerations that should be taken into account in further studies aimed at investigating the potential changes in quadriceps EMG activity during the squat as a result of trekking at high-altitude.

The Effects of Workload Difference Between Limbs in Plyometric and Strength Exercises in Reducing Asymmetry in Change of Direction Ability During Basketball Season.

ABSTRACT: Ujakovic, F, and Sarabon, N. The effects of workload difference between limbs in plyometric and strength exercises in reducing asymmetry in change of direction ability during basketball season. J Strength Cond Res 37(11): 2282-2288, 2023-The topic of interlimb asymmetries has recently been extensively investigated; despite that, intervention for purpose of reducing them have been narrowly examined. The present study investigated the effects of maximal strength and plyometric resistance training program with 3:1 workload ratio (nondominant to dominant side) on change of direction deficit (CoDdef) asymmetry during the basketball season. Thirty-six highly trained male basketball players (19.3 ± 4.9 years) from different age categories (U-17, U-19, and senior) were divided into 2 groups: the control group ( n = 18) and the intervention group ( n = 18). The intervention group performed once-a-week training that consisted of strength (Bulgarian split squats) and jumping (single-leg countermovement jumps [SLCMJs]) part in which nondominant-to-dominant workload ratio was 3:1 during the 8-week period. Preintervention and postintervention testing included single-leg isometric squat, SLCMJ, 10-m sprint, and 505 test. Analysis of covariance results showed a statistically significant difference with large effect size ( p < 0.05; η2 = 0.26) when preintervention asymmetry was included as covariate. Post hoc analysis showed a statistically significant decrease in mean CoDdef asymmetry between preintervention (11.88%) and postintervention (4.47%) testing ( p < 0.01, effect size [ES] = -1.37). Isometric squat strength increased on nondominant side in the intervention group ( p < 0.05; ES = 0.77). No other performance or asymmetry variable showed significant change. In conclusion, a 3:1 workload of nonspecific movement task in favor of nondominant limb is an effective training strategy to reduce CoDdef asymmetry during basketball season.

Validity of the German Version of Daily Activity Behaviours Questionnaire Among Older Adults.

Time spent in physical activity, sedentary behavior, and sleep collectively impact health of older adults. There is a need for valid self-reported methods for the assessment of movement behaviors across the entire 24-hr day. The aim of this study was to explore the validity of the German version of Daily Activity Behaviours Questionnaire (DABQ), the "Schlaf- und Aktivitätsfragebogen (SAF)," among older adults. Participants were asked to wear activity monitor (activPAL) for a period of 8 days and to complete the German version of DABQ. Seventy-seven participants (45 females; 68 ± 5 years of age) completed the protocol. Spearman's correlation coefficients between DABQ and activPAL estimates for time spent in sleep, sedentary behavior, light physical activity, and moderate to vigorous physical activity were .69, .35, .24, and .52, respectively. The German version of the DABQ showed satisfactory validity to be used in epidemiological research and population surveillance among older adults.

Influence of unilateral and bilateral knee extension fatigue protocols on inter-limb asymmetries assessed through countermovement jumps.

This study explores the sensitivity of jump type (unilateral and bilateral) and output variable (mean force, propulsive impulse, and jump height) to detect the changes in inter-limb asymmetries induced by unilateral and bilateral fatigue protocols. Thirty-eight individuals performed two testing sessions that consisted of (I) nine "pre-fatigued" countermovement jumps (CMJs; three bilateral and six unilateral [three with each leg]), (II) fatigue protocol and (III) nine "post-fatigued" CMJs. The testing sessions only differed in the fatigue protocol (five sets to failure against the 15-repetition maximum load using either the unilateral or bilateral knee extension exercise). The magnitude of all CMJ-derived variables (mean force, impulse, and jump height) decreased following both unilateral (p ≤ 0.002) and bilateral fatigue protocols (p ≤ 0.018). However, only unilateral protocol accentuated inter-limb asymmetries, which was detected for all variables during the unilateral CMJ (from -4.33% to -2.04%; all p < 0.05) but not during the bilateral CMJ (from -0.64% to 0.54%; all p > 0.05). The changes in inter-limb asymmetries following the unilateral and bilateral fatigue protocols were not significantly correlated between the unilateral and bilateral CMJs (rs ≤ 0.172). The unilateral CMJ should be recommended for the testing purposes over the bilateral CMJ due to its greater sensitivity to detect the selective effects of fatigue.

Effect of a High-Intensity Handball-Specific Fatigue Protocol Focused on the Leg Contralateral to the Throwing Arm on Interlimb Asymmetries.

ABSTRACT: Janicijevic, D, Pérez-Castilla, A, Miras-Moreno, S, Ortega-Becerra, M, Morenas-Aguilar, MD, Smajla, D, Sarabon, N, and García-Ramos, A. Effect of a high-intensity handball-specific fatigue protocol focused on the leg contralateral to the throwing arm on interlimb asymmetries. J Strength Cond Res 37(7): 1382-1389, 2023-This study aimed to elucidate which countermovement jump (CMJ) variant (unilateral or bilateral) is more sensitive to detect the decrement in kinetic CMJ-derived variables of the leg more actively involved in a handball-specific fatigue protocol. Seventeen female handball players (age: 20.6 ± 2.5 years) performed a fatigue protocol consisting of 8 repetitions of the following circuit separated by 10 seconds: 10 m sprint, 180° change of direction with the leg contralateral to the throwing arm, 10 m sprint with ball reception at 7 m, and handball throw preceded by a jump over a 40 cm hurdle with the leg contralateral to the throwing arm. Before and after the fatigue protocol, 6 unilateral CMJs (3 with each leg) and 3 bilateral CMJs were performed on a dual Kistler force platform (model 9260AA6). Bilateral CMJ height was reduced by 5.4% after the fatigue protocol (p < 0.001). However, the fatigue protocol did not promote any significant change in peak force, mean force, and propulsive impulse or in their asymmetry values (17 of 18 comparisons). The decrement of 6.1% during the unilateral CMJ in the propulsive impulse developed by the leg ipsilateral to the throwing arm (less involved in the fatigue protocol) was the only variable that reached statistical significance (p = 0.038). The pre-post fatigue changes in asymmetry values presented negligible correlations between both CMJ variants (rs = 0.01 to -0.19). These results suggest that neither unilateral nor bilateral CMJs are able to detect changes in interlimb asymmetries after a high-intensity handball-specific fatigue protocol.

The relationship between elastography-based muscle properties and vertical jump performance, countermovement utilization ratio, and rate of force development.

This study explored the relationships between passive muscle stiffness (shear modulus) and vertical jumping performance, countermovement utilization ratio (CUR) and rate of force development (RFD) in an attempt to unravel the mechanism that may explain the association between shear modulus and performance. 32 recreationally active participants (16 males, 16 females; age: 22.4 ± 5.1 years) participated. Shear modulus was assessed for the lateral and medial gastrocnemius (GL and GM), and vastus medialis (VM) and lateralis (VL) muscles using shear wave elastography. Squat jump (SJ) and countermovement (CMJ) jump were determined, with CUR being expressed as the ratio between the two. RFD in ankle and knee extension tasks was measured using isometric dynamometers. Our results suggest that within a heterogeneous group of recreational athletes, passive muscle stiffness is not related to RFD and jump performance, but positively related to CUR. In males, shear modulus of the GL was positively related to SJ height (r = 0.55). We also found inverse moderate correlations between VL and VM shear modulus and RFD in females only (r = -0.50 to -0.51), but this relationship was possibly affected by age and body fat content. Different mechanisms may underpin the association between shear modulus and performance depending on the muscle, task and population investigated.

2023 Padua Days of Muscle and Mobility Medicine: post-meeting Book of Abstracts.

The 2023 Padua Days of Muscle and Mobility Medicine (Pdm3) were held from March 29th to April 1st, 2023. Most of the abstracts were published electronically in the European Journal of Translational Myology (EJTM) 33 (1) 2023. Here we report the complete book of abstracts that confirms the interest of more than 150 scientists and clinicians from Austria, Bulgaria, Canada, Denmark, France, Georgia, Germany, Iceland, Ireland, Italy, Mongolia, Norway, Russia, Slovakia, Slovenia, Spain, Switzerland, The Netherlands and USA to gather to the Hotel Petrarca of Thermae of Euganean Hills, Padua, Italy for contributing and attending the Pdm3 (https://www.youtube.com/watch?v=zC02D4uPWRg). The 2023 Pdm3 started March 29th in the historic Aula Guariento of thePadua Galilean Academy of Letters, Arts and Sciences with the Lecture of Prof. Carlo Reggiani and ended in the late afternoon with the Lecture of Professor Terje Lømo after introductory words of Professor Stefano Schiaffino. The program followed in the Hotel Petrarca Conferenece Halls from March 30 to April 1, 2023. The extended topic interests of specialists in basic myology sciences and clinicians, collected under the umbrella neologism of Mobility Medicine, is stressed also by expansion of Sections of the EJTM Editorial Board (https://www.pagepressjournals.org/index.php/bam/board). We hope that Speakers of the 2023 Pdm3 and readers of EJTM will submit "EJTM Communications" to the European Journal of Translational Myology (PAGEpress, Pavia, Italy) by May 31, 2023 and/or invited review and original articles for the 2023 special issue: "Pdm3" of Diagnostics, MDPI, Basel, Switzerland due September 30, 2023.

Incidence and Duration of Sick Leave Due to Work-Related Musculoskeletal Disorders in the Accommodation and Food Services Activities Sector in Slovenia: A Nationwide 5-Year Observational Study.

OBJECTIVES: The aim of this study was to analyze Slovenian data on sick leave (SL) due to the most common work-related musculoskeletal disorders (MSDs) among workers in sector I "accommodation and food services activities" from the NACE Rev2 classification. METHODS: We investigated both SL incidence (i.e., number of cases) and disease severity (i.e., average SL duration) by body site, gender, age and divisions within the sector. In addition, trends in SL data (difference between 2015 and 2019) were analyzed. The effect of age group, gender and division was also assessed with relative risk (RR). RESULTS: Female gender was associated with higher risk of MSDs in young (RR = 1.91 (1.53-2.43)) and older (RR = 2.24 (1.90-2.65)) subgroups. Older age was associated with greater SL incidence and longer SL duration, regardless of gender and division within sector I. This was also reflected in relative risk calculations between older and younger groups (females: RR = 4.43; CI = 3.75-5.01; p < 0.001; males: RR = 3.71; CI = 2.89-4.77; p < 0.001). Low back disorders were the most frequent cause for SL, while lower limb disorders tended to cause the longest average SL. The SL durations were similar across divisions within the sector, while the incidence rate tended to be higher in the "accommodation" than the "food and beverage services" division. CONCLUSIONS: Special attention needs to be paid to reducing the risk of low back disorders, which are by far the most common cause of SL, and lower limb disorders, which cause the longest SL. We recommend the implementation of countermeasures that focus on early detection and rapid treatment/recovery of MSDs in older workers.

The prevalence and severity of sick-leaves due to musculoskeletal disorders among workers in water supply; sewerage, waste management and remediation activities.

The aim of this study was to analyse the nationwide data on sick leaves (SL) due to work-related musculoskeletal disorders among Slovenian workers in section E "water supply; sewerage, waste management and remediation activities" from NACE Rev2 classification. We report both, SL frequency (ie, number of cases) and SL severity (ie, average SL duration), stratified by body region, gender, age and divisions within the section. In addition, trends in SL data (year 2015-2019 difference) were analyzed. Throughout the analysed years, ∼9,000 workers were employed in the section, with male to female ratio at ∼ 4:1. The major findings are as follows: (i) low back disorders were by far the most prevalent, however, the mean SL duration was the highest for lower limb disorders; (ii) older age was associated with increased SL frequency and duration, irrespective of gender; (iii) male gender was consistently associated with larger SL duration, while the data on SL frequency is inconclusive, as older females had more frequent SL than older males; (iv) the effect of division was relatively minor and the comparisons are limited due to large discrepancies regarding the number of workers across divisions; (v) a slight increasing trend for both SL frequency and duration was observed from 2015 to 2019. In conclusion, particular attention in terms of early diagnosis and treatment of musculoskeletal disorders should be given to male workers and older workers in general in section E.

The influence of an 8-week therapeutic exercise program on the patient experience of patellofemoral pain: a qualitative descriptive study.

OBJECTIVE: The aim of this study was to explore patients' experience of patellofemoral pain (PFP), in order to help improve the mutual understanding between the patient and the physiotherapist and consequently enhance the efficacy of treatment. METHODS: A qualitative study design with focus groups was used to explore patient experience prior to the implementation of the therapeutic exercise program, during its duration, and up to twelve months after its conclusion. RESULTS: Patients provided a detailed description of their lifestyle prior to the enrollment in the therapeutic exercise program, their experience of the therapeutic exercise program and the behavioral changes that remained after its conclusion. Three main themes emerged from our data: 1) PFP characteristics and the impact of PFP on daily life; 2) experience with the therapeutic exercise program; and 3) changes in PFP and daily behaviors following the therapeutic exercise program. CONCLUSION: Our findings suggest that a targeted therapeutic exercise program effectively reduces short- and long-term PFP and enhance overall well-being. Further research is needed to investigate the effects of different therapeutic exercise programs with a focus on the role of self-motivation.

The Effects of Conservative Interventions for treating Diastasis Recti Abdominis in Postpartum Women: a Review with Meta-analysis.

Diastasis recti abdominis (DRA) is a common occurrence in postpartum women, and it is unclear what types of nonsurgical interventions are most effective in preventing and/or reducing it. The aim of this review with meta-analysis was to investigate which conservative treatment approaches are the most effective for the management of postpartum DRA. After a thorough search of the PubMed and Scopus databases, we reviewed 14 articles. The literature suggests that abdominal exercise programs are generally effective in treating DRA at various postpartum periods. There is preliminary but promising evidence of the efficacy of electrical stimulation in combination with exercise. In addition, abdominal kinesiotaping can be used in conjunction with other interventions. Limitations of previous research include (a) the use of different measurement methods (palpation, calipers, ultrasound) and sites, (b) the evaluation of treatment effects in different time periods, and (c) the use of a wider range of exercise combinations. Although abdominal exercise is a cornerstone of DRA treatment, the optimal exercise combination is currently unknown due to these limitations.