Does diastasis recti abdominis weaken pelvic floor function? A cross-sectional study

Abstract Objective There is a lack of consensus on which abdominal or pelvic floor muscle (PFM) exercises to recommend for the treatment of diastasis recti abdominis (DRA). The objective of this study was to investigate the immediate effect of abdominal and PFM exercises on interrecti distance (IRD) in women with DRA who are parous. Methods In this cross-sectional study, 38 women who were parous, with a mean age of 36.2 years (SD = 5.2), diagnosed with DRA participated. IRD was assessed with 2-dimensional real-time ultrasonography during rest and during 8 randomly ordered different exercises. A paired t test was used to compare the IRD at rest with the IRD recorded during each exercise as well as the differences between exercises. Means with 95% CI are reported. Results Head lift and twisted curl-up exercises significantly decreased the IRD both above and below the umbilicus. Above the umbilicus, the mean IRD difference from rest during head lift was 10 mm (95% CI = 7 to 13.2), whereas during twisted curl-up it was 9.4 mm (95% CI = 6.3 to 12.5). Below the umbilicus, the corresponding values were 6.1 mm (95% CI = 3.2 to 8.9) and 3.5 mm (95% CI = 0.5 to 6.4), respectively, but PFM contraction, maximal in-drawing, and PFM contraction + maximal in-drawing increased the IRD (mean difference = −2.8 mm [95% CI = −5.2 to 0.5], −4.7 mm [95% CI = −7.2 to −2.1], and − 5.0 mm [95% CI = −7.9 to −2.1], respectively). Conclusions Head lift and twisted curl-up exercises decreased the IRD both above and below the umbilicus, whereas maximal in-drawing and PFM contraction exercises only increased the IRD below the umbilicus. A randomized controlled trial is needed to investigate whether head lift and twisted curl-up exercises are effective in permanently narrowing the IRD. Impact To date there is scant scientific knowledge of which exercises to recommend in the treatment of DRA. In-drawing and PFM contraction leads to an acute increase in IRD, while head lift and twisted curl-up leads to an acute decrease in IRD in postpartum women. There is a need for high-quality randomized controlled trials to investigate if there is a long-term reduction in IRD by doing these exercises over time. The acute IRD increase and decrease during the different exercises is also present in a sample of women with larger separations.

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Which Exercises Close Diastasis Recti Abdominis In Parous Women? An Experimental Cross-sectional Study

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000680284.19925.f5 ◽

2020 ◽

Vol 52 (7S) ◽

pp. 557-558

Author(s):

Sandra Gluppe ◽

Marie E. Engh ◽

Kari Bo

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Experimental Cross ◽

Diastasis Recti ◽

Diastasis Recti Abdominis

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Normal width of the linea alba, prevalence, and risk factors for diastasis recti abdominis in adults, a cross-sectional study

Hernia ◽

10.1007/s10029-021-02493-7 ◽

2021 ◽

Author(s):

R. L. Kaufmann ◽

C. S. Reiner ◽

U. A. Dietz ◽

P. A. Clavien ◽

R. Vonlanthen ◽

...

Keyword(s):

Risk Factors ◽

Cross Sectional Study ◽

Reference Points ◽

Sectional Study ◽

Cross Sectional ◽

Equal Distribution ◽

Suspected Appendicitis ◽

Diastasis Recti ◽

Definition Of ◽

Diastasis Recti Abdominis

Abstract Aim The prevalence and definition of diastasis recti abdominis (DRA) is under debate. This retrospective cross-sectional study evaluated the interrectal distance and the prevalence of DRA in computed tomography (CT) in an asymptomatic population. Materials and methods Patients undergoing CT scans for suspected appendicitis or kidney stones from 01/2016 to 12/2018 were screened retrospectively to participate. A study population with equal distribution according to gender and age (18–90 years) was generated (n = 329 patients) and the interrectal distance was measured at six reference points. Results DRA (defined as > 2 cm at 3 cm above the umbilicus) was present in 57% of the population. The 80th percentile of the interrectal distance was 10 mm at the xiphoid (median 3 mm, 95% confidence interval (CI) 0–19 mm), 27 mm halfway from xiphoid to umbilicus (median 17 mm, 95% CI 0–39 mm), 34 mm at 3 cm above the umbilicus (median 22 mm, 95% CI 0–50 mm), 32 mm at the umbilicus (median 25 mm, 95% CI 0–45 mm), 25 mm at 2 cm below the umbilicus (median 14 mm, 95% CI 0–39 mm), and 4 mm halfway from umbilicus to pubic symphysis (median 0 mm, 95% CI 0–19 mm). In the multivariate analysis, higher age (p = 0.001), increased body mass index (p < 0.001), and parity (p < 0.037) were independent risk factors for DRA, while split xiphoid, tobacco abuse, and umbilical hernia were not. Conclusion The prevalence of DRA is much higher than commonly estimated (57%). The IRD 3 cm above the umbilicus may be considered normal up to 34 mm. To avoid over-treatment, the definition of DRA should be revised.

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Effect of re-approximation of the rectus muscles on diastasis recti abdominis at cesarean section — a prospective cross-sectional study

Ginekologia Polska ◽

10.5603/gp.a2020.0143 ◽

2021 ◽

Vol 92 (2) ◽

pp. 132-136

Author(s):

Ersin Çintesun ◽

Feyza Nur İncesu Çintesun ◽

Meltem Aydoğdu ◽

Denizhan Bayramoğlu ◽

Çetin Çelik

Keyword(s):

Cesarean Section ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Diastasis Recti ◽

Diastasis Recti Abdominis

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A cross-sectional study on pelvic floor symptoms in women living with Female Genital Mutilation/Cutting

Reproductive Health ◽

10.1186/s12978-021-01097-9 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Alzbeta Binkova ◽

Marion Uebelhart ◽

Patrick Dällenbach ◽

Michel Boulvain ◽

Angèle Gayet-Ageron ◽

...

Keyword(s):

Pelvic Floor ◽

Female Genital Mutilation ◽

Cross Sectional Study ◽

Background Information ◽

Sectional Study ◽

Cross Sectional ◽

Genital Mutilation ◽

Pelvic Floor Symptoms ◽

The Impact ◽

Female Genital

Abstract Background Female Genital Mutilation/Cutting (FGM/C) concerns over 200 million women and girls worldwide and is associated with obstetric trauma and long-term urogynaecological and psychosexual complications that are often under-investigated and undertreated. The aim of this study was to assess the pelvic floor distress and the impact of pelvic floor and psychosexual symptoms among migrant women with different types of FGM/C. Methods This cross-sectional study was conducted between April 2016 and January 2019 at the Division of Gynaecology of the Geneva University Hospitals. The participants were interviewed on socio-demographic and background information, underwent a systematic gynaecological examination to assess the presence and type of FGM/C and eventual Pelvic Organ Prolapse (POP), and completed six validated questionnaires on pelvic floor and psychosexual symptoms (PFDI-20 and PFIQ7 on pelvic floor distress and impact, FISI and WCS on faecal incontinence and constipation, PISQ-IR and FGSIS on sexual function and genital self-image). The participants’ scores were compared with scores of uncut women available from the literature. The association between selected variables and higher scores for distress and impact of pelvic floor symptoms was assessed using univariate and multivariable linear regression models. Results 124 women with a mean age of 31.5 (± 7.5), mostly with a normal BMI, and with no significant POP were included. PFDI-20 and PFIQ-7 mean (± SD) scores were of 49.5 (± 52.0) and 40.7 (± 53.6) respectively. In comparison with the available literature, the participants’ scores were lower than those of uncut women with pelvic floor dysfunction but higher than those of uncut women without such disorders. Past violent events other than FGM/C and forced or arranged marriage, age at FGM/C of more than 10, a period of staying in Switzerland of less than 6 months, and nulliparity were significantly associated with higher scores for distress and impact of pelvic floor symptoms, independently of known risk factors such as age, weight, ongoing pregnancy and history of episiotomy. Conclusions Women with various types of FGM/C, without POP, can suffer from pelvic floor symptoms responsible for distress and impact on their daily life. Trial registration. The study protocol was approved by the Swiss Ethics Committee on research involving humans (protocol n°15-224).

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