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The prevalence of abdominal diastasis is high in postpartum. The abdominal diastasis can impair the body posture, the of lumbo-pelvic stability and movement, or breathing. Exercises focused on the transversus abdominis muscle have been proposed as a therapeutic approach for abdominal diastasis.
Hypopressive abdominal exercises have been used for postpartum recovery, for specific pathologies related to pregnancy (low back pain, pelvic floor dysfunction ...) and even for the rehabilitation of spinal pathologies. However, there is a lack of studies that determine its effectiveness and clinical utility.
The aim of the study will be to analyze the effects of Hypopressive abdominal exercises on postpartum abdominal diastasis, the tone of the transverse abdominal muscle and the pelvic floor musculature.
A case series design will be applied, with weekly assessment of the outcomes after the intervention and two months after the intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hypopressive abdominal exercises | Experimental | Hypopressive abdominal exercises will be performed in basic postures (standing, sitting and supine position). In each posture, three slow cost-diaphragmatic respiration will be performed followed by an expiratory apnea and a rib cage opening, during 2 to 10 seconds, and an exhalation of 10 to 30 seconds. Each exercise will be repeated three times. There will be 3 stages of application throughout the 12 intervention sessions, supervised by a physical therapist: First stage: To explain the concept of hypopressive respiration and how to perform it. Second stage: To explain and apply the hypopressive abdominal exercises: 1. Axial auto-elongation (reducing curvatures in the sagittal plane); 2. Cervical auto-elongation (chin toward the neck); 3. Moving forward of gravity axis; 4. Activation of the shoulder girdle (shoulder joint decoaptation); 5. Slight knee flexion; 6. Dorsal ankle flexion. Third stage: To review and update all the exercises, increasing their intensity. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hypopressive abdominal exercises | Other | Three sessions per week during four consecutive weeks (Total: 12 sessions). Each session time: 30 minutes. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Abdominal Diastasis - Baseline | Supraumbilical distance between the rectus abdominis
| Pre-intervention |
| Abdominal Diastasis - post-intervention 1 | Supraumbilical distance between the rectus abdominis
| Immediately after the intervention |
| Abdominal Diastasis - post-intervention 2 | Supraumbilical distance between the rectus abdominis
| One month after the intervention |
| Abdominal Diastasis - post-intervention 3 | Supraumbilical distance between the rectus abdominis
| Two months after the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Abdominal tonometry - Baseline | Tonometric evaluation on the white line (linea alba) and the abdominal muscles
| Pre-intervention |
| Perineal tonometry - Baseline |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Daiana Priscila Rodrigues-de-Souza, PhD | Universidad de Córdoba | Study Director |
| Miriam RamÃrez Jiménez, Phys Ther | Universidad de Córdoba | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Córdoba | Córdoba | 14004 | Spain |
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Tonometric evaluation on the perineal muscles
|
| Pre-intervention |
| Waist circumference - Baseline | Waist circumference
| Pre-intervention |
| Chest circumference - Baseline | Chest circumference
| Pre-intervention |
| Abdominal tonometry - post-intervention 1 | Tonometric evaluation on the white line (linea alba) and the abdominal muscles
| Immediately after the intervention |
| Perineal tonometry - post-intervention 1 | Tonometric evaluation on the perineal muscles
| Immediately after the intervention |
| Waist circumference - post-intervention 1 | Waist circumference
| Immediately after the intervention |
| Chest circumference - post-intervention 1 | Chest circumference
| Immediately after the intervention |
| Abdominal tonometry - post-intervention 2 | Tonometric evaluation on the white line (linea alba) and the abdominal muscles
| One month after the intervention |
| Perineal tonometry - post-intervention 2 | Tonometric evaluation on the perineal muscles
| One month after the intervention |
| Waist circumference - post-intervention 2 | Waist circumference
| One month after the intervention |
| Chest circumference - post-intervention 2 | Chest circumference
| One month after the intervention |
| Abdominal tonometry - post-intervention 3 | Tonometric evaluation on the white line (linea alba) and the abdominal muscles
| Two months after the intervention |
| Perineal tonometry - post-intervention 3 | Tonometric evaluation on the perineal muscles
| Two months after the intervention |
| Waist circumference - post-intervention 3 | Waist circumference
| Two months after the intervention |
| Chest circumference - post-intervention 3 | Chest circumference
| Two months after the intervention |