Effects of Barre-Based Core Stability With and Without Tupler Technique on Core Strength, Inter Recti Distance, and Pelvic Floor Function Among Diastasis Recti Abdominis Patients
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 58
- 试验地点
- 1
- 主要终点
- Inter-Recti Distance (IRD)
研究概览
简要总结
This study will be a single blind, parallel group randomized controlled trial designed to evaluate the effectiveness of Barre-based core stability training with and without the Tupler Technique in postpartum women with Diastasis Recti Abdominis. A total of 58 eligible participants will be recruited from postpartum care units and randomly assigned in a 1:1 allocation ratio to either an experimental group receiving Barre-based core stability training combined with the Tupler Technique or a control group receiving Barre-based core stability training alone.
Both interventions will be delivered under supervised conditions three times per week for 8 weeks, with each session lasting approximately 30-45 minutes. The Barre-based program focuses on controlled low impact movements aimed at improving deep core muscle activation, postural alignment, and neuromuscular coordination. The experimental group will additionally receive the Tupler Technique, which includes abdominal splinting, progressive core strengthening exercises, and neuromuscular re-education targeting approximation of the rectus abdominis muscles and improved abdominal wall function.
Outcome measures include inter-recti distance, core strength, and pelvic floor function. Secondary outcomes include postural stability and functional performance. Assessments will be conducted at baseline, mid-intervention (week 4), post-intervention (week 8), and follow-up (week 12) by blinded outcome assessors to minimize bias.
The purpose of this trial is to determine whether combining the Tupler Technique with Barre-based core stability training provides superior improvements in abdominal separation, core strength, pelvic floor function, and functional ability compared with Barre-based training alone in postpartum women.
详细描述
Diastasis Recti Abdominis (DRA) is a postpartum musculoskeletal condition characterized by separation of the rectus abdominis muscles due to weakening of the linea alba, resulting in impaired core stability, reduced pelvic floor function, altered lumbopelvic mechanics, and decreased functional performance. Management is primarily conservative and involves exercise-based rehabilitation targeting abdominal wall integrity and neuromuscular control.
Barre-based core stability training is a low impact exercise intervention focusing on postural alignment, controlled movement, and activation of deep core musculature, including the transversus abdominis and pelvic floor muscles. The Tupler Technique is a structured rehabilitation program for DRA that includes abdominal splinting, progressive core strengthening, and neuromuscular re-education to improve rectus abdominis approximation and abdominal wall function.
This single blind, parallel group randomized controlled trial will recruit 58 postpartum women diagnosed with DRA. Participants will be randomly allocated using concealed assignment in a 1:1 ratio to either an experimental group receiving Barre-based core stability training combined with the Tupler Technique or a control group receiving Barre-based training alone.
Both groups will receive supervised interventions three times per week for 8 weeks, with each session lasting 30-45 minutes. The exercise protocol emphasizes controlled activation of deep core muscles, postural control, and safe functional movement patterns. The experimental group will additionally perform abdominal splinting and structured neuromuscular re-education as part of the Tupler Technique.
Outcome measures will include inter-recti distance, core strength, pelvic floor function, postural stability, and functional performance. Assessments will be conducted at baseline, week 4, week 8, and week 12 by blinded outcome assessors. Data will be analyzed to compare within group and between group changes over time, using appropriate statistical methods under an intention-to-treat approach.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
This will be a single blinded study in which the outcome assessors and data collectors will be blinded to group allocation to minimize assessment bias. Participants and therapists will not be blinded due to the nature of the exercise interventions.
入排标准
- 年龄范围
- 18 Years 至 40 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Women aged 18-40 years
- •Postpartum period between 6-12 months
- •Diagnosed with stage I-II Diastasis Recti Abdominis
- •Presence of symptoms such as abdominal weakness or back pain
- •Ability to follow exercise instructions
排除标准
- •Stage III Diastasis Recti Abdominis
- •Severe hernias or significant pelvic floor dysfunction
- •Neurological, cardiovascular, or systemic conditions contraindicating exercise
- •History of abdominal surgery or trauma affecting the abdominal wall
结局指标
主要结局
Inter-Recti Distance (IRD)
时间窗: Baseline (Day 0), Week 4, Week 8, Week 12
Inter-recti distance (IRD) will be measured to assess the separation of the rectus abdominis muscles in women with Diastasis Recti Abdominis. Measurements will be taken using ultrasound imaging and calipers at standardized anatomical points (above, at, and below the umbilicus). IRD will be recorded in centimeters. A reduction in IRD indicates improvement in abdominal wall integrity and core stability.
Core Strength
时间窗: Baseline (Day 0), Week 4, Week 8, Week 12
Core strength will be assessed using the Modified Sahrmann Test, which evaluates lumbopelvic control and activation of deep core muscles during progressive lower limb movements. Performance will be scored based on the ability to maintain neutral spine alignment without compensatory movements such as pelvic tilt or abdominal bulging. Higher scores indicate better core strength and neuromuscular control.
Pelvic Floor Function
时间窗: Baseline (Day 0), Week 4, Week 8, Week 12
Pelvic floor function will be assessed using the Pelvic Floor Distress Inventory (PFDI-20), a validated questionnaire measuring symptom severity related to urinary, colorectal, and prolapse distress. Scores range from 0 to 300, with higher scores indicating greater dysfunction. A reduction in score indicates improvement in pelvic floor function.
Postural Stability
时间窗: Baseline (Day 0), Week 4, Week 8, Week 12
Postural Stability Postural stability will be assessed using the Balance Error Scoring System (BESS). Participants perform balance tasks in double-leg, single-leg, and tandem stance on firm and foam surfaces. Errors (e.g., stepping, loss of balance, opening eyes) are counted. Lower scores indicate better postural control.
Functional Performance
时间窗: Baseline (Day 0), Week 4, Week 8, Week 12
Functional performance will be assessed using the Physical Functioning (PF-10) subscale of the SF-36 Health Survey. The scale evaluates limitations in activities such as walking, climbing stairs, lifting, and carrying objects. Scores range from 0 to 100, with higher scores indicating better functional ability.
次要结局
未报告次要终点