Effects of Tupler's Technique on the Management of Diastasis Rectus Abdominis.

Not Applicable

Recruiting

Brief Summary: Diastasis Rectus Abdominis is the condition in which two abdominal muscles rectus abdominis separated and cause widening and thinning of Linea alba. The Tupler's Technique is Evidence Based intervention for the management of Diastasis Rectus Abdominis. The purpose of this study is to see the Effectiveness of Tupler's Technique on the Management of Diastasis Rectus Abdomins in Post-Partum Females.

Detailed Description: Literature suggest that during pregnancy due to hormonal changes such as increased in Relaxin, estrogen and progesterone level and also increased in the size of uterus affect the aponeurosis connection of abdominal muscles and due to these changes Diastasis Rectus Abdominis is common during pregnancy especially in third trimester and in the post-partum period. we can measure diastasis rectus abdominis by different methods such as palpatory, caliper and ultrasound. The condition can be mild (two fingers gap), moderate (two to three fingers gap) and severe (more than three fingers gap). The separation of greater than 2cm is considered as Diastasis Rectus Abdominis.

In this study effectiveness of Tupler's Technique will be assessed in post-partum diastasis rectus abdominis patients. Patients will have to wear diastasis rehab splints and then perform tupler's technique exercises. The mechanism behind this is when patients wear splint the splint will keep the connective tissues in narrow position for better healing and strengthening of muscles will be done by Tuper's Technique exercises and Diastasis of Rectus Abdominis willl be treated.

Recruitment & Eligibility

Inclusion Criteria

Primiparous and multiparous females (Vaginal delivery).
Greater than and equal to 12 weeks post-partum
Age limit will be18-30 years
BMI under or equa to 29kg/m2
Visiting with the complain of low back pain
Diastasis of rectus abdominis at the level of umbilicus with mild, moderate and severe condition.

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Control Group	Traditional Exercises	Traditional treatment protocol will be applied to this group that includes traditional exercises for diastasis rectus abdominis and this protocol will be followed 3 times per week for 6 weeks.
Interventional Group	Tupler's Technique	Tupler's Technique will be applied to this group. This technique includes Tupler's technique exercises and patients will also wears diastasis rehab splints. Patients will perform seated isometric exercises (elevator and contracting exercises) after wearing diastasis rehab splint. Repetitions of exercises will be 100 and whole intervention will be provided for 6 weeks.

Primary Outcome Measures

Name	Time	Method
Numeric Pain rating scale	Before intervention, after 3 weeks and after 6 weeks.	By using this scale we will measure the intensity of back pain. i scores pain from 0-10. 0 means no pain, 5 means moderate pain and 10 means severe pain.
Maternal post-partum quality of life instrument (MPQOL-I)	Before intervention, after 3 weeks and after 6 weeks.	This questionnaire has 5 domains. psychological, reltion with family and friends, relation with spouse, socioeconomic and health related domain and we can assess every domain of female life.
Digital nylon caliper to measure inter-recti Distance	Before intervention, after 3 weeks and after 6 weeks.	Digital nylon caliper is the valid and reliable instrument to measure the inter-recti distance and inter-recti distance will be measured at three levels. at the level of umbilicus, 4.5cm above umbilicus and 4.5cm below umbilicus.
Oswestry low bac pain disability Questionnaire	Before intervention, after 3 weeks and after 6 weeks.	This is a valid tool to assess back pain and this questionnaire has 10 sections and we grade level of disability according to grading criteria. 0-4shows no disability, 5-14 shows mild disability, and 15-24 shows moderate disability, and 25-34 shows severe disability and grade 35-50 means completely disabled.

Secondary Outcome Measures

Name	Time	Method

Locations (2): Allied Hospital Faisalabad
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Faisalābad, Punjab, Pakistan
Madinah Teaching Hospital Faisalabad
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Faisalābad, Punjab, Pakistan