Physiotherapy in women with diastasis of the rectus abdominis muscles

Background
Diastasis of the rectus abdominis muscles (DRAM) is the separation of the two rectus abdominis muscles more than 2 cm wide. It often arises as a result of android obesity, dysfunctional abdominal cramp and pregnancy. Untreated diastasis may lead to dangerous heath consequences such as.: abdominal hernia, lower back pain or disorders in pelvis’s area. The aim of this study was to determinate the effectiveness of novel physiotherapeutic program in women with diastasis of the rectus abdominis muscles.

Material and methods
The study was conducted on a group of 40 women between 20-45 years old (mean 32,32+5,9 year). They all were qualified in obstetric ward of Szpital Bielański in Warsaw. All of them were in the postpartum between 0-3 days after labor and have DRAM greater than 2 cm (measured by palpation on the umbilicus height, 4,5 cm above and below umbilicus). In research group (included 20 women) applied novel physiotherapeutic program aimed at reduction of DRAM. In controlled group (20 women) there was no therapy but only observation of spontaneous reduction of diastasis. The study took 6 weeks.

Results
Data analysis had shown 95% effectiveness of novel physiotherapeutic program. Chi-square test has confirmed the difference in DRAM size in both groups (p<0,0001). A statistically significant correlation was demonstrated between width of diastasis and growth of the mother’s weight gain in pregnancy, waist-to-hip ratio, BMI, number of delivery and mother’s physical activity before and during pregnancy (p<0,05). There wasn’t clear correlation between width of diastasis and mother’s age or infant’s mass (p>0,05).

Conclusions
It seems that spontaneous reduction of diastasis of the rectus abdominis muscles is very rare. New physiotherapeutic program is an effective method in DRAM’s reduction. The research should be continued in larger group of women and after effectiveness confirmation, program should be introduced in obstetric wards.