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Diastasis rectus abdominis (DRA) is defined as an excessive separation between the two abdominal rectus muscles. It is generally quantified by the inter-recti distance. In postpartum women, the prevalence of diastasis is 60% six weeks after delivery.
The increase in the inter-recti distance has been associated with a decrease in strength and endurance of the trunk flexors and rotators (p < 0.05). Exercise during pregnancy has been shown to be helpful in the treatment of DRA. Nevertheless, there is still not strong evidence to establish what kind of exercise should be recommended during pregnancy and in postpartum.
The aim of this study is to compare the morphological and functional changes of the linea alba during four exercises.
Inter-recti distance, linea alba thickness and distortion index will be measured at rest, as well as during 4 exercises (draw in maneuver, crunch, pelvic floor muscle contraction and a "de Gasquet" exercise). Subgroup analysis will be performed to determine if the presence or absence of an abdominal diastasis has an influence on these outcomes.
A cross-sectional pilot study will be carried out. The main outcome measure will the inter-recti distance. Secondary outcomes will be the thickness of linea alba and distortion index.
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| Measure | Description | Time Frame |
|---|---|---|
| Inter-recti distance | The distance between the two medial borders of rectus abdominis muscles is measured using ultrasound | During the exercise |
| Measure | Description | Time Frame |
|---|---|---|
| Linea alba thickness | Linea alba thickness is measured using ultrasound | During the exercise |
| Distortion index of the linea alba | Average deviation of the linea alba from the shortest path between the recti measured using ultrasound |
| Measure | Description | Time Frame |
|---|---|---|
| Transversus abdominis thickness | Transversus abdominis thickness at 1cm lateral from the fascia transversalis measured using ultrasound | During the exercise |
| Current lumbopelvic pain intensity | Current lumbopelvic pain will be measured using a visual analog scale |
Inclusion Criteria:
Exclusion Criteria:
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Adult parous women attending to several physiotherapy centers in Paris will be recruited
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Montserrat Rejano-Campo, MSc | Contact | 0033627083914 | montserejano@gmail.com |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41794408 | Derived | Rejano-Campo M, Fuentes-Aparicio L, de Gasquet B. Immediate Effect of Four Exercises on Linea Alba Thickness, Distortion and Inter-Recti Distance in Parous Women. Physiother Res Int. 2026 Apr;31(2):e70185. doi: 10.1002/pri.70185. |
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| ID | Term |
|---|---|
| D000070630 | Diastasis, Muscle |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D004204 | Joint Dislocations |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D014947 | Wounds and Injuries |
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| During the exercise |
| During the assessement |
| Acute lumbopelvic pain severity | The participants will be asked about their lumbopelvic pain mean intensity in the last week using a visual analog scale | During the assessement |
| Chronic lumbopelvic pain severity | The participants will be asked about their lumbopelvic pain mean intensity in the last 6 months using a visual analog scale | During the assessement |
| Urinary symptoms | Urinary symptoms will be measured using the Urinary Symptom Profile questionnaires | During the assessement |
| D001519 |
| Behavior |