Hypopressive Abdominal Exercise in Postpartum Abdominal Diastasis

Not Applicable

Completed

• Conditions: Abdominal Diastasis
• Interventions: Other: Hypopressive abdominal exercises

• Registration Number: NCT04238156
• Lead Sponsor: Universidad de Córdoba

Brief Summary

The prevalence of abdominal diastasis is high in postpartum. The abdominal diastasis can impair the body posture, the of lumbo-pelvic stability and movement, or breathing. Exercises focused on the transversus abdominis muscle have been proposed as a therapeutic approach for abdominal diastasis.

Hypopressive abdominal exercises have been used for postpartum recovery, for specific pathologies related to pregnancy (low back pain, pelvic floor dysfunction ...) and even for the rehabilitation of spinal pathologies. However, there is a lack of studies that determine its effectiveness and clinical utility.

The aim of the study will be to analyze the effects of Hypopressive abdominal exercises on postpartum abdominal diastasis, the tone of the transverse abdominal muscle and the pelvic floor musculature.

A case series design will be applied, with weekly assessment of the outcomes after the intervention and two months after the intervention.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-01-15
• Study First Submitted QC: 2020-01-18
• Study Start: 2020-01-20
• Study First Posted: 2020-01-23
• Status Verified: 2020-07
• Primary Completion: 2020-07-20
• Study Completion: 2020-07-20
• Last Update Submitted: 2020-07-20
• Last Update Posted: 2020-07-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 15

Inclusion Criteria

• primiparous or multiparous
• abdominal diastasis previously diagnosed
• commitment to perform, at least, 80% of the exercises
• signed informed consent

Exclusion Criteria

• BMI > 40 Kg/m2
• pelvic floor disorders before childbirth
• drugs with effects on continence or functional properties of the pelvic floor muscles
• treatment for abdominal diastasis in the last 6 months
• systemic disease that impairs pelvic floor physiology and urination
• menopause
• contraindications to the practice of physical exercise and physical therapy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Hypopressive abdominal exercises	Hypopressive abdominal exercises	Hypopressive abdominal exercises will be performed in basic postures (standing, sitting and supine position). In each posture, three slow cost-diaphragmatic respiration will be performed followed by an expiratory apnea and a rib cage opening, during 2 to 10 seconds, and an exhalation of 10 to 30 seconds. Each exercise will be repeated three times. There will be 3 stages of application throughout the 12 intervention sessions, supervised by a physical therapist: First stage: To explain the concept of hypopressive respiration and how to perform it. Second stage: To explain and apply the hypopressive abdominal exercises: 1. Axial auto-elongation (reducing curvatures in the sagittal plane); 2. Cervical auto-elongation (chin toward the neck); 3. Moving forward of gravity axis; 4. Activation of the shoulder girdle (shoulder joint decoaptation); 5. Slight knee flexion; 6. Dorsal ankle flexion. Third stage: To review and update all the exercises, increasing their intensity.

Primary Outcome Measures

Name	Time	Method
Abdominal Diastasis - post-intervention 3	Two months after the intervention	Supraumbilical distance between the rectus abdominis; * Assessment tool: caliper (electronic, calibrated, precision: 1 mm); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Abdominal Diastasis - Baseline	Pre-intervention	Supraumbilical distance between the rectus abdominis; * Assessment tool: caliper (electronic, calibrated, precision: 1 mm); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Abdominal Diastasis - post-intervention 1	Immediately after the intervention	Supraumbilical distance between the rectus abdominis; * Assessment tool: caliper (electronic, calibrated, precision: 1 mm); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Abdominal Diastasis - post-intervention 2	One month after the intervention	Supraumbilical distance between the rectus abdominis; * Assessment tool: caliper (electronic, calibrated, precision: 1 mm); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical

Secondary Outcome Measures

Name	Time	Method
Perineal tonometry - Baseline	Pre-intervention	Tonometric evaluation on the perineal muscles; * Assessment tool: (MyotonPro (R)); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Waist circumference - Baseline	Pre-intervention	Waist circumference; * Assessment tool: tape measure (flexible, precision: 1mm); * Subject position: standing; * Localization: minimum perimeter
Abdominal tonometry - post-intervention 1	Immediately after the intervention	Tonometric evaluation on the white line (linea alba) and the abdominal muscles; * Assessment tool: (MyotonPro (R)); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Abdominal tonometry - Baseline	Pre-intervention	Tonometric evaluation on the white line (linea alba) and the abdominal muscles; * Assessment tool: (MyotonPro (R)); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Chest circumference - Baseline	Pre-intervention	Chest circumference; * Assessment tool: tape measure (flexible, precision: 1mm); * Subject position: standing; * Localization: maximum perimeter
Perineal tonometry - post-intervention 1	Immediately after the intervention	Tonometric evaluation on the perineal muscles; * Assessment tool: (MyotonPro (R)); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Waist circumference - post-intervention 1	Immediately after the intervention	Waist circumference; * Assessment tool: tape measure (flexible, precision: 1mm); * Subject position: standing; * Localization: minimum perimeter
Chest circumference - post-intervention 1	Immediately after the intervention	Chest circumference; * Assessment tool: tape measure (flexible, precision: 1mm); * Subject position: standing; * Localization: maximum perimeter
Abdominal tonometry - post-intervention 2	One month after the intervention	Tonometric evaluation on the white line (linea alba) and the abdominal muscles; * Assessment tool: (MyotonPro (R)); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Waist circumference - post-intervention 2	One month after the intervention	Waist circumference; * Assessment tool: tape measure (flexible, precision: 1mm); * Subject position: standing; * Localization: minimum perimeter
Chest circumference - post-intervention 2	One month after the intervention	Chest circumference; * Assessment tool: tape measure (flexible, precision: 1mm); * Subject position: standing; * Localization: maximum perimeter
Abdominal tonometry - post-intervention 3	Two months after the intervention	Tonometric evaluation on the white line (linea alba) and the abdominal muscles; * Assessment tool: (MyotonPro (R)); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Perineal tonometry - post-intervention 2	One month after the intervention	Tonometric evaluation on the perineal muscles; * Assessment tool: (MyotonPro (R)); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Perineal tonometry - post-intervention 3	Two months after the intervention	Tonometric evaluation on the perineal muscles; * Assessment tool: (MyotonPro (R)); * Subject position: supine; * Localization: 3 cm, 6 cm, 9 cm, 12 cm supraumbilical
Waist circumference - post-intervention 3	Two months after the intervention	Waist circumference; * Assessment tool: tape measure (flexible, precision: 1mm); * Subject position: standing; * Localization: minimum perimeter
Chest circumference - post-intervention 3	Two months after the intervention	Chest circumference; * Assessment tool: tape measure (flexible, precision: 1mm); * Subject position: standing; * Localization: maximum perimeter

Trial Locations

Locations (1)

University of Córdoba; 🇪🇸 Córdoba, Spain