Abstract
Background: Diastasis recti is defined as an interrecti distance (IRD) over 23 mm in Beninese postpartum women. Its prevalence is 46%. The Curl-up acutely reduces the IRD but it increases the linea alba distortion
and it is considered to be hyperpressive. When Curl-up is combined with Diaphragmatic aspiration (DA) the intra-abdominal pressure is lower. Moreover, combining Curl-up with transversus abdominis activation
is recommended to decrease the linea alba distortion. However, the effect of this DA combined with Curlup on the IRD is not known in postpartum women.
Objectives: To study the acute effect of the DA combined with Curl-up, and of other abdominal exercises on IRD.
Methods: Beninese postpartum women diagnosed with diastasis recti participated in this cross-sectional study. IRD was measured at 5 cm above umbilicus with an ultrasound in 6 conditions performed in random order: rest, DA, Curl-up, Drawing-in, DA+Curl-up, Drawing-in+Curl-up. Values were expressed as median ± IQR and IRD was compared across these conditions using Friedman test and Wilcoxon test for post-hoc pairwise comparisons.
Results: Forty-nine women aged between 22 and 39 participated in this study. Compared to rest (26.7 ± 9.5 mm), no significant IRD difference was observed during either DA (26.0 ± 8.5 mm) or Drawing-in (29.0
± 10.0 mm), but IRD during Drawing-in was significantly larger than that during DA. Curl-up (18.7 ± 8.9 mm), Drawing-in+Curl-up (22.9 ± 9.7 mm) and DA+Curl-up (21.8 ± 9.3 mm) decreased the IRD (p<0.001). This decrease was the largest during Curl-up (p<0.001).
Conclusion: Compared to rest, DA and Drawing-in did not decrease IRD but their combination with Curlup slightly decreased IRD. Future studies are needed to investigate the acute effect of the combination of DA with Curl-up on the linea alba distortion.
Clinical Implication: Physiotherapists are regularly confronted with the management of the diastasis recti in postpartum women. DA combined with Curl-up can be used for management of diastasis recti in postpartum.
Keywords
Interrecti distance, Diaphragmatic aspiration, Hypopressive exercise, Curl-up, Ultrasound, Postpartum women, Benin