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    Comparison of Trunk Muscle Function Between Women With and Without Diastasis Recti Abdominis at 1 Year Postpartum. Hills Nicole F,Graham Ryan B,McLean Linda Physical therapy Background:A separation of the abdominal muscles at the linea alba, known as diastasis recti abdominis (DRA), can occur after childbirth. However, the impact of DRA on abdominal muscle function is not clear. Objective:The objective was to determine if differences exist in trunk muscle function and self-reported pain and low back dysfunction between women with and without DRA at 12 to 14 months postpartum and if differences that emerge from the data are associated with the magnitude of the interrectus distance (IRD). Design:This study was a prospective, observational, case-control study. Methods:Women with (IRD ≥ 2.2 cm; n = 18) and without DRA (IRD < 2.2 cm; n = 22) participated. Maximal trunk flexion, extension, and rotation torque-generating capacity (Newton-meters), the Sit-Up test (0 to 3 points), and the Sitting-Rising Test (0 to 10 points), and trunk flexion, extension, and lateral flexion endurance (seconds) were measured. Pain and disability were assessed using numerical pain rating scales (0 to 100) and the Roland Morris Low Back Pain Questionnaire (0 to 24 points). Women were compared using independent t tests and Mann-Whitney U Tests. Pearson product-moment and Spearman rank correlation coefficients were used to determine associations; a = .05 was used for all tests. Results:Women with DRA demonstrated significantly lower trunk muscle rotation torque and scored lower on the sit-up test than those without DRA. IRD was negatively correlated with both trunk rotation torque (rho = -0.367) and sit-up test score (rho = -0.514). Limitations:The results of this study should not be generalized to women who present with moderate-to-severe IRDs or to multiparous women. Conclusion:The presence of DRA in primiparous women at 1 year postpartum is associated with trunk rotation strength and ability to perform a sit-up. 10.1093/ptj/pzy083
    Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Fernandes da Mota Patrícia Gonçalves,Pascoal Augusto Gil Brites Andrade,Carita Ana Isabel Andrade Dinis,Bø Kari Manual therapy Diastasis recti abdominis (DRA) is an impairment characterized by a midline separation of the rectus abdominis muscles along the linea alba. It has its onset during pregnancy and the first weeks following childbirth. There is scant knowledge on both prevalence and risk factors for development of the condition. The aim of this study was to investigate the prevalence of DRA at gestational week 35 and three timepoints postpartum, possible risk factors, and the relationship between DRA and lumbo-pelvic pain. Ultrasound images of inter rectus distance (IRD) were recorded in 84 healthy primiparous women, at three locations on the linea alba. The IRD was measured at: gestational week 35 and 6-8, 12-14, and 24-26 weeks postpartum. Diagnosis of DRA was defined as 16 mm at 2 cm below the umbilicus. Independent sample t-test and binary logistic regression was used to assess differences and risk factors in women with and without DRA and women with and without lumbo-pelvic pain. P < 0.05 was considered statistically significant. The prevalence of DRA decreased from 100% at gestational week 35-39% at 6 months postpartum. No statistically significant differences were found in prepregnancy body mass index (BMI), weight gain, baby's birth weight or abdominal circumference between women with and without DRA at 6 months postpartum. Women with DRA at 6 months postpartum were not more likely to report lumbo-pelvic pain than women without DRA. DRA is prevalent at 6 months postpartum, but is not linked with lumbo-pelvic pain. 10.1016/j.math.2014.09.002
    Association Among Pelvic Girdle Pain, Diastasis Recti Abdominis, Pubic Symphysis Width, and Pain Catastrophizing: A Matched Case-Control Study. Physical therapy OBJECTIVE:Pregnancy-related pelvic girdle pain (PGP) may persist or occur postpartum and negatively affects women's lives. There is uncertainty regarding the association between the structures of the bony pelvis, diastasis recti abdominis (DRA), pain processing, and PGP and to what extent these factors should be considered during physical therapy. This study aimed to evaluate the differences between women with and without PGP shortly after delivery regarding the separation of a pubic symphysis, DRA, and pain catastrophizing. METHODS:Women diagnosed with PGP 24 to 72 hours after vaginal delivery were matched to pain-free controls according to age and parity. Ultrasound evaluations of diastasis recti (interrecti distance [IRD]) during rest and curl-up task and pubic symphysis (interpubic width) were performed. The Pain Catastrophizing Scale was used to assess the level of catastrophizing. A special Cox regression model was used to fit a conditional logistic regression for a 1:2 matched case-control study. RESULTS:Thirty-five women with clinically diagnosed PGP and 70 matched controls were included in the study. The PGP group had a significantly higher pre-pregnancy body mass index than the control group. After adjusting for body mass index in multiple conditional logistic regression, the interpubic distance (odds ratio = 1.64; 95% CI = 1.22 to 2.20) and IRD during curl-up (odds ratio = 2.01; 95% CI = 1.08 to 3.74) were significantly associated with PGP. Pain catastrophizing and IRD at rest were not associated with PGP in univariable or multivariable analysis. CONCLUSIONS:Pain catastrophizing is similar for women with and without PGP early postpartum. However, the degree of the pubic symphysis and rectus abdominis separation during the curl-up task are positively associated with PGP shortly after delivery. IMPACT:This study indicates that a reconsideration of the way we look at DRA is warranted. The development of a more comprehensive assessment including objective measurements and a biopsychosocial understanding is needed to inform directions for further postpartum physical therapy. 10.1093/ptj/pzab311
    Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: Prevalence, risk factors and its impact on life. Wu Lina,Gu Yechun,Gu Yanlan,Wang Yawen,Lu Xueqin,Zhu Cong,Lu Zhongqiu,Xu Hongbo Journal of clinical nursing AIMS AND OBJECTIVES:This study aimed to obtain the incidence of diastasis recti abdominis (DRA) and analyse possible risk factors in adult females. Moreover, the relationships between DRA and lower back pain, pelvic floor function and quality of life were also analysed. BACKGROUND:Diastasis recti abdominis is a separation of the abdominal muscles at the linea alba. Currently, studies on the prevalence rates, risk factors and consequences of DRA are varied. In particular, reports on DRA among adult women are lacking. DESIGN:A one-sample questionnaire study design is used following the STROBE checklist. METHODS:The inter-rectus distance was measured by computed tomography in 644 women. Custom questionnaires, the Oswestry Disability Index, The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were used to investigate personal information, the subjects' back pain, pelvic floor function and quality of life, respectively. RESULTS:The incidence of DRA was 28.4%. Age, the number of pregnancies, BMI and diabetes were influencing factors for DRA. After age stratification, pregnancy and diabetes were found to be risk factors for DRA in young women, and obesity and diabetes were risk factors for DRA in older women. This study showed that the association between DRA and low back pain was highly significant. CONCLUSIONS:Diastasis recti abdominis is common in adult women. Avoiding multiple pregnancies, preventing diabetes and controlling weight may prevent DRA, which may be beneficial for decreasing low back pain in women. RELEVANCE TO CLINICAL PRACTICE:The findings have important implications for the health of adult women which can provide the basis for appropriate nursing implementation for DRA patients. The application of specific prevention and intervention measures for the risk factors may reduce the severity of low back pain. 10.1111/jocn.15568
    The relationship of severity in diastasis recti abdominis and pelvic floor dysfunction: a retrospective cohort study. Fei Hui,Liu Yun,Li Mengxiong,He Juan,Liu Lixiang,Li Juanhua,Wan Ying,Li Tian BMC women's health BACKGROUND:Diastasis of rectus abdominis (DRA) refers to a separation of the rectus abdominis from the linea alba. This study aimed to investigate the association with the severity of DRA for developing pelvic floor dysfunction among women during the first year postpartum. METHODS:This is a retrospective cohort study which collected data from 229 postpartum women. DRA was defined as a separation of ≥ 20 mm at any point 4.5 cm above, at and 4.5 cm below the umbilicus. The data for analysis includes pelvic organ prolapse quantification (POP-Q), medical history of urinary incontinence (UI), the strength of rectus abdominis muscle and pelvic floor muscle. The differences in women with and without DRA were compared with independent samples t-test and Chi-square test. RESULTS:Prevalence of DRA was 82.6% during the first postpartum year. Cesarean section and multiple parturitions are recognized as risk factors for DRA due to the odds ratio in our study were 3.48 (95% CI 1.42-8.56), 3.20 (95% CI 1.59-6.45) respectively. There was no difference in the occurrence of UI and pelvic organ prolapse (POP) comparing women with and without DRA, even changing the cut-off values (inter-rectus distance = 20 mm, 30 mm, 40 mm, 50 mm) for determining DRA. The women with weak rectus abdominis muscle and pelvic floor muscle have no statistical difference in two group. CONCLUSION:The relationship of the diastasis recti abdominis and pelvic floor dysfunction has no connection, even with the severity of inter-rectus distance increasing. 10.1186/s12905-021-01194-8
    Investigate Correlation between Diastasis of Rectus Abdominis Muscle and Low Back Pain in Obese Women. Puri Jahanvi,Sharma Sunita,Samuel Asir John,Chahal Aksh Journal of lifestyle medicine Background:Rectus abdominis is the main core muscle. Weakness or any alteration in it may increase the pressure over the lower back, in obese women diastasis of rectus abdominis muscle found to be very common condition. Therefore, there may be a correlation between diastasis of rectus abdominis muscle and low back pain in obese women that needs to be explored, as there is no literature available. Methods:In this study, 72 female subjects with Body Mass Index <30 kg/m were recruited by snowball sampling method. Demographic (name, age) and anthropometric characteristics (height, weight and body mass index) were recorded. The separation in the rectus abdominis muscle was assessed with vernier calliper. Results:Total subjects were included in the study; all the subjects were Female without any recent abdominal surgical history. The subjects included in the study with age of 30 years to 55 years old with body mass index of the included females must be (30-30.9) kg/m i.e. women must come under obese category. Diastasis of rectus abdominis muscle was another variable used that must be present in each women. Low back pain was also used as the variable that may be present or may not be present in the women with diastasis of rectus abdominis muscle. The collected data were analysed by the appropriate statistical analysis tools. The p-value was found more than 0.05 (the alpha level set was less than 0.05) which is non-significant. Conclusion:The study concluded a non-significant correlation between the diastasis of rectus abdominis muscle and low back pain in obese women. The present study concludes that it is not necessary that all obese women with low back pain always propose to have diastasis of rectus abdominis muscle. 10.15280/jlm.2021.11.1.38