Effect of Pilates Exercises on Diastasis Recti Abdominis in Postpartum Women

Not Applicable

Completed

• Conditions: Diastasis Recti
• Interventions: Other: Abdominal belt; Other: Pilates exercises

• Registration Number: NCT06311201
• Lead Sponsor: Cairo University

Brief Summary

The purpose of the study was to investigate the effect of Pilates exercises on diastasis recti abdominis in postpartum women.

Detailed Description

Rectus diastasis is relatively common having negative health consequences for women during and after pregnancy (ante-and postnatal periods). Varying estimates of incidence of rectus diastasis have been reported ranging from 66% to 100% during the third trimester of pregnancy, and up to 53% immediately after delivery. Among patients with urogynecological disorders, 52% were found to have a rectus diastasis and 66% had at least one type of pelvic floor dysfunction.

A diastasis can contribute to lower back pain and strain due to other muscles being overworked or compensating for the lack of integrity of abdominals, unstable core, pelvic and back muscles, poor posture, shallow breathing and uterine prolapse. This may result in altered trunk mechanics, impaired pelvic stability and changed posture, which leave the lumbar spine and pelvis more vulnerable to injury.

Facilitation, concentric activation, and stabilization of the abdominal muscles occurred during core stability exercise are used to correct diastasis recti. Pilates has been known to improve the strength and flexibility of muscles, particularly the abdominal muscles, lower back, hip and buttocks i.e. the core musculature thus helping in improving core stability.

Uptill now, there was no previous studies have examined the impact of Pilates training on rectus abdominis diastasis in postpartum women. So, this study will be valuable benefits for medical services organizations and will increase body of knowledge of physical therapists in scientific field.

Study Timeline

• Study Start: 2023-09-26
• Primary Completion: 2024-01-26
• Study Completion: 2024-01-26
• Status Verified: 2024-03
• Study First Submitted: 2024-03-08
• Study First Submitted QC: 2024-03-08
• Study First Posted: 2024-03-15
• Last Update Submitted: 2024-03-17
• Last Update Posted: 2024-03-19

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 50

Inclusion Criteria

1. Postpartum women (7 days after delivery) having diastasis recti (separation between the two recti more than 2.5cm at the level of umbilicus).
2. Multiparous women (2-3) times delivered vaginally with or without episiotomy.
3. Their age ranged from 20 -35 years old.
4. Their BMI was less than 30 kg/cm2.

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Exclusion Criteria

1. Abdominal or back surgery.
2. Abdominal hernia.
3. History of abnormal pregnancy, uterine fibroid or polyhydraminos during pregnancy.
4. Neurological disorders as multiple sclerosis, stroke and spinal lesion.
5. Musculoskeletal diseases such as fractures muscle strains, severe knee osteoarthritis which may affect their physical activity.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Abdominal belt + Pilates exercises	Pilates exercises	It consisted of 25 postpartum women who followed Pilates training program, 3 times/week for 1 hour the session in addition to wearing abdominal belt, for 8 weeks
Abdominal belt + Pilates exercises	Abdominal belt	It consisted of 25 postpartum women who followed Pilates training program, 3 times/week for 1 hour the session in addition to wearing abdominal belt, for 8 weeks
Abdominal belt	Abdominal belt	It consisted of 25 postpartum women who wore abdominal belt for 8 weeks.

Primary Outcome Measures

Name	Time	Method
Measurement of separation between the two-rectus abdominis muscles below the umbilicus during contraction	8 weeks	The distance between the recti muscles was measured 4.5 cm below the umbilicus during contraction at the beginning and again at the end of the study duration.
Assessment of static trunk flexion endurance	8 weeks	It was tested before and after the end of the study program by adopting the most challenging position that was achieved in the strength test, and instructing the participating women to hold that position as long as possible. Standardized verbal encouragement was provided by the assessor, and the holding time was determined using a stopwatch. Three repetitions of the static endurance test were performed with at least 3 minutes of rest between trials; the best (longest holding time) of the three trials was used to represent the participant's endurance. The same position used to evaluate trunk flexion endurance at the initial evaluation was used in subsequent evaluations, even if the woman's strength grade improved between evaluations.
Measurement of separation between the two-rectus abdominis muscles above the umbilicus at rest	8 weeks	The distance between the recti muscles was measured 4.5 cm above the umbilicus at rest at the beginning and again at the end of the study duration.
Measurement of separation between the two-rectus abdominis muscles at level of the umbilicus during contraction	8 weeks	The distance between the recti muscles was measured at level of the umbilicus during contraction at the beginning and again at the end of the study duration.
Assessment of trunk flexion strength	8 weeks	Trunk flexion strength was graded from 0 to 5 using Daniels and Worthingham's procedure before and after the end of the study program. For grades 3-5, the patient curled up through the full range of motion until the scapulae cleared the table. For grade 2, the patient just lifted their head off the table. For grades 0 and 1, the therapist used assisted forward lean or coughing techniques while palpating the rectus abdominis.
Measurement of separation between the two-rectus abdominis muscles above the umbilicus during contraction	8 weeks	The distance between the recti muscles was measured 4.5 cm above the umbilicus during contraction at the beginning and again at the end of the study duration.
Measurement of separation between the two-rectus abdominis muscles at level of the umbilicus at rest	8 weeks	The distance between the recti muscles was measured at level of the umbilicus at rest at the beginning and again at the end of the study duration.
Measurement of separation between the two-rectus abdominis muscles below the umbilicus at rest	8 weeks	The distance between the recti muscles was measured 4.5 cm below the umbilicus at rest at the beginning and again at the end of the study duration.

Secondary Outcome Measures

Name	Time	Method
Assessment of functional status	8 weeks	All participating women with diastasis recti in both groups (A \& B) were asked to fill the Inventory of functional status after childbirth questionnaire before and after the end of the study program. This questionnaire includes five domains and 36 items, that is, infant care (6 items), personal care (8 items), household activities (12 items), social and community activities (6 items), and occupational activities (4 items). The questionnaire was rated on a 4-point Likert scale and the mean score was calculated with one point being the lowest and four points being the highest scores possible. Higher scores indicated better functional status.

Trial Locations

Locations (1)

Cairo University; 🇪🇬 Giza, Egypt