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Meta-Analysis
. 2021 Nov-Dec;25(6):664-675.
doi: 10.1016/j.bjpt.2021.06.006. Epub 2021 Jul 21.

What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis

Sandra Gluppe  1 , Marie Ellström Engh  2 , Kari Bø  3
Affiliations
Meta-Analysis

What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis

Sandra Gluppe et al. Braz J Phys Ther. 2021 Nov-Dec.

Abstract

Background: Diastasis recti abdominis (DRA) affects a significant number of women in the postpartum period.

Objective: To systematically review whether abdominal and pelvic floor muscle (PFM) exercise programs are effective in the treatment of DRA postpartum.

Methods: Electronic search was conducted from inception to March 2020. Randomized controlled trials (RCT) or pilot RCTs that compared abdominal training, PFM training, or a combination of both in at least one arm of the trial were included. The primary outcome was presence of DRA (numbers/percentage) or inter-recti distance (IRD) change. GRADE was used to rate the overall quality of evidence. Pooled effect sizes were expressed as mean difference (MD) with 95% confidence intervals (CI).

Results: Seven RCTs totaling 381 women were included. Two studies comparing transversus abdominis (TrA) training with minimal intervention provided data to be included in a meta-analysis. The results provided very low level quality evidence that TrA training reduced IRD (MD = -0.63 cm, 95% confidence interval: -1.25, -0.01, I2 = 0%). Two studies included curl-up exercises as part of their intervention. Level of evidence based on single trials of high risk of bias show very low evidence that curl-up training is more effective than minimal intervention for treating DRA. Similarly, analyses based on single trials provided low to very low quality evidence that PFM training is not more effective than minimal intervention for treating DRA.

Conclusion: There is currently very low-quality scientific evidence to recommend specific exercise programs in the treatment of DRA postpartum.

Keywords: Diastasis recti abdominis; Exercise; Pelvic floor muscle; Postpartum; Treatment.

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Conflict of interest statement

Conflicts of interest There was no conflict of interest in this study.

Figures

Fig. 1
Figure 1
Forest plot on the effect of abdominal training on inter-recti distance in women with diastasis recti abdominis.
See this image and copyright information in PMC

References

    1. Venes D., Taber C. 22. ed. FA Davis Co; Philadelphia: 2013. Taber's Cyclopedic Medical Dictionary.
    1. Sperstad J.B., Tennfjord M.K., Hilde G., Ellstrom-Engh M., Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med. 2016;50(17):1092–1096. - PMC - PubMed
    1. Benjamin D.R., van de Water A.T., Peiris C.L. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy. 2014;100(1):1–8. - PubMed
    1. Fernandes da Mota P.G., Pascoal A.G., Carita A.I., Bø K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther. 2015;20(1):200–205. - PubMed
    1. Turan V., Colluoglu C., Turkyilmaz E., Korucuoglu U. Prevalence of diastasis recti abdominis in the population of young multiparous adults in Turkey. Ginekol Pol. 2011;82(11):817–821. - PubMed