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Clinical Trials/NCT07520409
NCT07520409
Recruiting
Not Applicable

Combine Effects of Drawing in Maneuver and Resisted Ankle Dorsiflexion on Pain, Inter-recti Distance, Strength and Quality of Life in Postpartum Diastasis Recti

Riphah International University1 site in 1 country42 target enrollmentStarted: October 1, 2025Last updated:

Overview

Phase
Not Applicable
Status
Recruiting
Enrollment
42
Locations
1
Primary Endpoint
Numeric Pain Rating Scale

Overview

Brief Summary

The aim of this study is to compare the combine effects of drawing in maneuver and resisted ankle dorsiflexion on pain, inter-recti distance, strength and quality of life in postpartum diastasis recti.

Detailed Description

Randomized controlled research will assess how drawing-in maneuver and resisted ankle dorsiflexion together affect postpartum women with diastasis recti in terms of pain, inter-recti distance, abdominal strength, and quality of life. 20-40 years females from 6 weeks to 6 months to post-partum period will be included in this study and the data will be collected from Al Zahra Hospital, Ali medical center and Sharif Medical Complex. Two groups of 42 individuals will be randomly assigned to either the drawing-in maneuver alone (Group A, n = 21) or a combination of the drawing-in technique and resisted ankle dorsiflexion (Group B, n = 21). For six weeks, the intervention will be administered twice a week to both groups. Manual muscle testing for strength, caliper measurement for IRD, the SF-36 questionnaire for quality of life and the Numeric Pain Rating Scale (NPRS) for pain will all be used in baseline and post-treatment evaluations. The data will be analyzed using IBM SPSS Statistics version 25.

Study Design

Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel
Primary Purpose
Treatment
Masking
Single (Outcomes Assessor)

Eligibility Criteria

Ages
20 Years to 45 Years (Adult)
Sex
Female
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • Postpartum females (6 weeks to 6 months postpartum)
  • Diagnosed with diastasis recti (IRD ≥ 2.5 cm)
  • Age 20-45 years
  • Mode of delivery
  • Multiparity

Exclusion Criteria

  • History of abdominal surgery
  • Pelvic organ prolapses
  • Neurological or orthopedic disorders
  • Presence of low back pain, hernia, or musculoskeletal disorders
  • Participation in any other abdominal rehabilitation program in the last 3 months

Arms & Interventions

DRAWING IN MANEUVER & RESISTED ANKLE DORSIFLEXION

Experimental

Drawing-In Maneuver (DIM), also known as the abdominal drawing-in maneuver, which is widely recognized as a foundational exercise for deep core activation

Intervention: DRAWING IN MANEUVER (Other)

DRAWING IN MANEUVER & RESISTED ANKLE DORSIFLEXION

Experimental

Drawing-In Maneuver (DIM), also known as the abdominal drawing-in maneuver, which is widely recognized as a foundational exercise for deep core activation

Intervention: RESISTED ANKLE DORSIFLEXION (Other)

DRAWING IN MANEUVER

Active Comparator

Resisted Ankle Dorsiflexion contributes to core muscle engagement through kinetic chain activation.

Intervention: DRAWING IN MANEUVER (Other)

Outcomes

Primary Outcomes

Numeric Pain Rating Scale

Time Frame: 6th week

This scale examines the subjective degree of pain severity is estimated using a horizontal line on a standardized self-reporting scale. The pain level is represented by an 11-point numerical scale. There is no pain (0), mild pain (1-2-3), moderate pain (4-5-6), and severe pain (7-8-9-10).

Caliper Measurement

Time Frame: 6th week

To assess inter-recti distance at reference points (above, at, and below the umbilicus) the caliper will be used. To measure inter-recti distance 4.5 cm above and below the umbilicus (indicated with skin markings), the inside jaws of the calipers are placed between the medial edges of the right and left rectus abdominis muscles as palpated by the examiner

Manual Muscle Testing (MMT)

Time Frame: 6th week

. Manual Muscle Testing (MMT) is a widely used clinical method to evaluate the strength of individual muscles or muscle groups on a standardized 0 to 5 scale. A grade of 0 indicates no visible or palpable muscle contraction, while 1 (Trace) denotes a slight muscle flicker without any movement. A grade 2 (Poor) means the muscle can complete full range of motion only when gravity is eliminated. Grade 3 (Fair) signifies the ability to move the joint through the full range of motion against gravity, but not against any resistance. Grade 4 (Good) indicates that the muscle can perform against moderate resistance, and grade 5 (Normal) represents full strength with the ability to resist maximal manual pressure

SF-36

Time Frame: 6th week

The SF-36 (Short Form-36 Health Survey) is a validated and reliable questionnaire used to assess health-related quality of life across eight domains, including physical functioning, bodily pain, general health, vitality, social functioning, and mental health. Each domain is scored from 0 to 100, with higher scores indicating better quality of life

Secondary Outcomes

No secondary outcomes reported

Investigators

Sponsor Class
Other
Responsible Party
Sponsor

Study Sites (1)

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