Effect of progressive prone plank exercise program on diastasis of rectus abdominis muscle in postpartum women: A randomized controlled trial

Authors

  • Eman Awad Beni-Suef University, Egypt
  • Ali Mobark Beni-Suef University, Egypt
  • Ahmed A. Zidan Beni-Suef University, Egypt
  • Hamada A. Hamada Cairo University, Egypt
  • Tamer Shousha University of Sharjah & Cairo University, United Arab Emirates

Keywords:

Diastasis rectus abdominis, Inter-rectus distance, Rectus Abdominis, Ultrasonography, Measurement, Prone plank exercise

Abstract

Diastasis of Rectus Abdominis (DRA) muscle is a concerning health issue that commonly affects female within pregnancy and postpartum time, persistent lower back pain and pelvic instability are common consequences to DRA. Thus, this study was conducted to examine the effect of progressive prone plank exercises on narrowing the inter-Rectus distance (IRD) in postpartum women diagnosed with (DRA). A prospective, randomized, single-blind, controlled trial was conducted at the Faculty of Physical Therapy Clinic of Beni-Suef University. Fifty postpartum women presented with (DRA) of at least 2 finger widths assigned into 2 equal groups (A&B). A Toshiba Xario100, 8–12 MHz ultrasonography was used to accurately measure IRD before and after 8 weeks of the exercise program. Group (A), received progressive prone plank exercise program and advice relevant to DRA as well as wore abdominal binder, while group (B) continued their ordinary lifestyle after receiving advice and wearing abdominal binder as group (A).The study results revealed a statistical significant decrease within each group and between groups in IRD (p < .05) above and below the umbilicus both at rest and during Rectus Abdominis (RA) contraction, with a significantly narrower IRD in favoured of participants of group (A) (p < .05). To sum it up, progressive prone plank exercise program is very effective in decreasing IRD in postpartum women presented with DRA.

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References

Akuthota, V., Ferreiro, A., Moore, T., & Fredericson, M. (2008). Core Stability Exercise Principles. Curr Sports Med Rep, 7(1), :39-44. https://doi.org/10.1097/01.CSMR.0000308663.13278.69

Bates-Maves, J. K., & O'Sullivan, D. (2017). Trauma-informed risk assessment in correctional settings. International Journal of Criminology and Sociology, 6, 93-102. https://doi.org/10.6000/1929-4409.2017.06.10

Benjamin, D.R., van de Water, A.T., & Peiris, C.L. (2014). Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy, 100, 1-8. https://doi.org/10.1016/j.physio.2013.08.005

Chiarello, C.M., Falzone, L.A., McCaslin, K.E., Patel, M.N., & Ulery, K.R. (2005). The Effects of an exercise program on diastasis recti abdominis in pregnant women. J Women's Health PhysTher, 29, 11-6. https://doi.org/10.1097/01274882-200529010-00003

Chiarello, C.M., Zellers, J.A., & Sage-King, F.M. (2012). Predic¬tors of inter-recti distance in cadavers. J Womens Health PhysTher, 36, 125-130. https://doi.org/10.1097/JWH.0b013e318276f60e

Coldron, Y., Stokes, M.J., Newham, D.J., & Cook, K. (2008). Postpartum characteristics of rectus abdominis on ultrasound imaging. Man Ther, 13, 112-21. https://doi.org/10.1016/j.math.2006.10.001

Ekstrom, R.A., Donatelli, R.A., & Carp, K.C. (2007). Electromyographic analysis of core trunk, hip, and thigh muscles during 9 rehabilitation exercises. J Orthop Sports PhysTher, 37, 754-62. https://doi.org/10.2519/jospt.2007.2471

El-Mekawy, H., Eldeeb, A., El- Lythy, M., & El-Begawy, A. (2013). Effect of Abdominal Exercises versus Abdominal Supporting Belt on Post-Partum Abdominal Efficiency and Rectus Separation. Int J Med Health Sci, 7(1), 75-9.

Feldwieser, F.M., Sheeran, L., Meana-Esteban, A., et al. (2012). Electromyographic analysis of trunk-muscle activity during stable, unstable and unilateral bridging exercises in healthy individuals. Eur Spine J, 21(Suppl 2), S171-86. https://doi.org/10.1007/s00586-012-2254-7

Gitta, S., Magyar, Z., Tardi, P., et al. (2016). How to Treat Diastasis Recti Abdominis with Physical Therapy: A Case Report. J Diseases, 3(2), 16-20. https://doi.org/10.18488/journal.99/2016.3.2/99.2.16.20

Imai, A., Kaneoka, K., Okubo, Y., et al. (2010). Trunk muscle activity during lumbar stabilization exercises on both a stable and unstable surface. J Orthop Sports PhysTher, 40, 369-75. https://doi.org/10.2519/jospt.2010.3211

Keeler, J., Albrecht, M., Eberhardt, L., Horn, L., Donnelly, C., & Lowe, D. (2012). Diastasis recti abdominis: a survey of women's health specialists for current physical therapy clinical practice for postpartum women. J Women's Health PhysTher, 36, 131-42. https://doi.org/10.1097/JWH.0b013e318276f35f

Keshwani, N., Mathur, S., & McLean, L. (2017). Relationship between Inter-rectus Distance and Symptom Severity in Women with Diastasis Recti in the Early Postpartum Period. Physical therapy. Dec 4. https://doi.org/10.1093/ptj/pzx117

Khandale, S.R., & Hande, D. (2016). Effects of abdominal exercises on reduction of diastasis recti in postnatal women. Int J Health Sci Res, 6(6), 182-191.

Lee B.C.Y., McGill, S.M. (2015). Effect of long-term isometric training on core/torso stiffness. J Strength Cond Res, 29, 1515-26. https://doi.org/10.1519/JSC.0000000000000740

Lehman, G.J., Hoda, W., Oliver, S. (2005). Trunk muscle activity during bridging exercises on and off a Swiss ball. ChiroprOsteopat, 13, 14. https://doi.org/10.1186/1746-1340-13-14

Litos, K. (2014). Progressive Therapeutic Exercise Program for Successful Treatment of a Postpartum Woman with a Severe Diastasis Recti Abdominis. J Womens Health PhysTherap, 38(2), 58-73. https://doi.org/10.1097/JWH.0000000000000013

Maurice Nahabedian, D.C. (2018). Brooks. "Rectus abdominis diastasis". UpToDate. Retrieved 2018-01-26. Topic 100494 Version 5.0.

Mota, P., Pascoal, A.G., Carita, A.I., & Bø, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther, 20, 200-5. https://doi.org/10.1016/j.math.2014.09.002

Mota, P., Pascoal, A.G., Carita, A.I., & Bo, K. (2015). The immediate effects on inter-rectus distance of abdominal crunch and drawing-in exercises during pregnancy and the postpartum period. J Orthopaed Sports Phys Ther, 45, 781-8. https://doi.org/10.2519/jospt.2015.5459

Mota, P., Pascoal, A.G., Sancho, F., & Bo, K. (2012). Test-retest and intraraterreliability of 2-dimensional ultrasound measurements of distance between rectus abdominis in women. J Orthopaed Sports Phys Ther, 42, 940-6. https://doi.org/10.2519/jospt.2012.4115

Mota, P., Pascoal, A.G., Sancho, F., Carita, A.I., & Bø, K. (2013). Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements. Man Ther, 18, 294-8. https://doi.org/10.1016/j.math.2012.10.013

Opala-Berdzik, A., & Dabrowski, S. (2009). Physiotherapy in diastasis of the rectus muscles of abdomen in women during pregnancy and postpartum. Fizjoterapia, 17(4), 67-70. https://doi.org/10.2478/v10109-010-0039-2

Parker, M., Millar, L., & Dugan, S. (2009). Diastasis rectus abdominis and lumbo-pelvic pain and dysfunction - Are they related? JWomens' Health PhysTherap, 33(2), 15-22. https://doi.org/10.1097/01274882-200933020-00003

Rathi, M. (2013). Effect of pelvic floor muscle strengthening exercises in chronic low back pain. IJPOT, 7(1), 121-5.

Sancho, M.F., Pascoal, A.G., Mota, P., & Bø, K. (2015). Abdominal exercises affect inter-rectus distance in postpartum women: a two-dimensional ultra-sound study. Physiotherapy, 101, 286-91. https://doi.org/10.1016/j.physio.2015.04.004

Sheykh, S. F. M., & Emadian, S. O. (2020). Investigating the Relationship between the Conflict Resolution Skills among Couples on the Level of Marital Conflict and Their Mental Health (Case Study: Centers of Psychological and Counseling Services of Qaemshahr City). Journal of Social Sciences and Humanities Research, 8(1).

Snijders, T., Verdijk, L.B., Beelen, M., McKay, B.R., Parise, G., Kadi, F., & Van Loon, L.J. (2012). A single bout of exercise activates skeletal muscle satellite cells during subsequent overnight recovery. ExpPhysiol, 97(6), 762-73. https://doi.org/10.1113/expphysiol.2011.063313

Sperstad, J.B., Tennfjord, M.K., Hilde, G., Ellström-Engh, M., & Bø, K. (2016). Dias-tasis recti abdominis during pregnancy and 12 months after childbirth:prevalence, risk factors and report of lumbopelvic pain. Br J SportsMed, 50, 1092-6. https://doi.org/10.1136/bjsports-2016-096065

Stephenson, R.G., & O'connor, L.J. (2000). Obstetric and gynecologic care in physical therapy, 2nd Ed. New York: Slack incorporated press.

Teyhen, D.S., Rieger, J.L., Westrick, R.B., Miller, A.C., Molloy, J.M., & Childs, J.D. (2008). Changes in deep abdominal muscle thickness during common trunk-strengthening exercises using ultrasound imaging. J Orthop Sports PhysTher, 38, 596-605. https://doi.org/10.2519/jospt.2008.2897

Van de Water, A.T., & Benjamin, D.R. (2016). Measurement methods to assess diastasis of the rectus abdominis muscle (DRAM): a systematic review of their measurement properties and meta-analytic reliability generalization. Manual therapy, 1(21), 41-53. https://doi.org/10.1016/j.math.2015.09.013

Walton, L., Costa, A., LaVanture, D., McIlrath, S., & Stebbins, B. (2016). The effects of a 6 week dynamic core stability plank exercise program compared to a traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, oswestry disability index (ODI)and pelvic floor disability index scores (PFDI). PhyTherRehab, 3(1), 3. https://doi.org/10.7243/2055-2386-3-3

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Published

2021-03-22

How to Cite

Awad, E., Mobark, A., Zidan, A. A., Hamada, H. A., & Shousha, T. (2021). Effect of progressive prone plank exercise program on diastasis of rectus abdominis muscle in postpartum women: A randomized controlled trial. Journal of Human Sport and Exercise, 16(2proc), S395-S403. Retrieved from https://www.jhse.ua.es/article/view/2021-v16-n2-proc-effect-progressive-prone-plank-exercise-program