Diastasis of rectus abdominis muscles in low back pain patients

Doubkova, Lucie; Andel, Ross; Palascakova-Springrova, Ingrid; Kolář, Pavel; Kříž, Jiří; Kobesová, Alena

doi:10.3233/bmr-169687

Cited by 44 publications

(32 citation statements)

References 37 publications

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“…The rectus abdominis plays an important role in posture, trunk and pelvis stability, respiration, trunk movement and abdominal organ support (Benjamin et al, 2014). For these reasons, DRA may contribute to chronic low back pain (Doubkova et al, 2018), have an impact on life (Gitta et al, 2017) and require surgery (Cheesborough, & Dumanian, 2015). There is an intervention research showing that postpartum back pain will be alleviated, muscle elasticity will be increased, and maternal body will recover as soon as possible when DRA condition improves (Wei et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…In the presence of DRA, interventions are largely determined by the severity and its impact on the patient's life. Common measurement methods are as follows: finger width method (Keshwani et al, 2018; Sperstad et al, 2016), ultrasonic (Doubkova et al, 2018; Fernandes da Mota et al, 2015; Liaw et al, 2011), callipers (Gitta et al, 2017) and CT (Emanuelsson et al, 2016). In general, there is a certain error rate in using finger method (Keshwani et al, 2018) and calliper method (Chiarello & McAuley, 2013) to measure DRA, while it is more accurate using B‐ultrasound (Doubkova et al, 2018) and CT (Emanuelsson et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: Prevalence, risk factors and its impact on life

et al. 2020

Journal of Clinical Nursing

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: Prevalence, risk factors and its impact on life

et al. 2020

Journal of Clinical Nursing

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“…However, it remains unclear whether the DRA actually causes these symptoms or not. Although inconclusive, persistent lower back pain after pregnancy has been reported in 11–21 per cent of postpartum women.…”

Section: Introductionmentioning

confidence: 99%

“…However, it remains unclear whether the DRA actually causes these symptoms or not. Although inconclusive 7,8,14 , persistent lower back pain after pregnancy has been reported in 11-21 per cent of postpartum women 15 -17 . The management of DRA is also a subject of discussion. Conservative management with training and weight loss is generally advised as first-line treatment.…”

Section: Introductionmentioning

confidence: 99%

Cohort study of the effect of surgical repair of symptomatic diastasis recti abdominis on abdominal trunk function and quality of life

et al. 2019

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BackgroundDuring pregnancy, women are at risk of developing persistent symptomatic diastasis recti abdominis (DRA), which may have a detrimental effect on their physical function and quality of life (QoL). The aim of this prospective cohort study was to determine the effect of surgical repair of DRA on abdominal trunk function, urinary incontinence and QoL in postpartum women with trunk instability symptoms resistant to training.MethodsPostpartum women with diagnosed DRA and training‐resistant symptoms underwent double‐row plication of the linea alba. Abdominal trunk function was evaluated as the primary endpoint using a multimodal examination tool, the Abdominal Trunk Function Protocol. Recurrence was assessed by CT, urinary incontinence was evaluated using the Urogenital Distress Inventory (UDI‐6) and Incontinence Impact Questionnaire (IIQ‐7), and QoL was assessed with the Short Form 36 (SF‐36®) questionnaire. All subjects were examined before and 1 year after surgery.ResultsSixty women were recruited. There was no DRA recurrence at the 1‐year follow‐up. Self‐reported abdominal trunk function had improved in 98 per cent of patients, with a mean score improvement of 79·1 per cent. In the physiological tests monitored by a physiotherapist, 76 per cent performed better and endured exercise tests longer than before surgery. All SF‐36® subscales improved significantly compared with preoperative scores and reached levels similar to, or higher than, the normative Swedish female population. For the UDI‐6 and IIQ‐7, 47 and 37 per cent respectively reported fewer symptoms at follow‐up than before surgery, and 13 and 8 per cent respectively reported more symptoms.ConclusionIn this series of postpartum women presenting with DRA and symptoms of trunk instability resistant to training, surgical reconstruction resulted in a significant improvement in abdominal trunk function, urinary incontinence and QoL.

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“…The motor control and function of the abdominal wall are in turn related to lumbopelvic pain [ 5 ]. However, even though an association between increased IRD and lumbopelvic pain has been suggested [ 4 , 6 ], several findings dispute this relationship [ 1 , 7 ]. There seems to be no conclusive evidence linking the condition of increased IRD to deteriorated physical function [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Women’s experiences of living with increased inter-recti distance after childbirth: an interview study

Crommert

Fieril²,

Gustavsson

2020

BMC Women's Health

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Background Although an increased inter-recti distance, also known as diastasis recti, is common after pregnancy, evidence-based knowledge about the condition is relatively limited. In particular, little is known about the consequences as perceived by the women. The objective of the present study was to describe how postpartum women with increased inter-recti distance experience the condition as well as the contacts they have had with healthcare providers regarding their symptoms. Methods A purposeful sampling approach was used to recruit 19 participants from an existing study cohort of 144 women. All participants had an inter-recti distance of at least two finger widths and at least one child, with the youngest child between the ages of 1 and 6 years. Individual interviews based on a semi-structured interview guide were performed and subsequently analysed using qualitative content analysis. Results Four categories emerged from the interviews: the body’s function and ability has changed; the body does not look like it used to; uncomprehending attitudes and treatment in their surroundings; and trying to acquire an understanding of and strategies to cope with the diastasis. The findings reveal that women with increased inter-recti distance might experience fear of movement and engage in avoidance behaviour. In combination with feelings of physical instability in the midsection of their bodies and body dissatisfaction, many of the women restrict their everyday lives and physical activities. Conclusions The findings indicate that increased inter-recti distance is a complex phenomenon that affects the women in a multitude of ways, highlighting the importance of considering the condition for each individual in her own context from a biopsychosocial perspective.

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Diastasis of rectus abdominis muscles in low back pain patients

Abstract: DRA and LBP may be interrelated, especially among men. This may be a function of greater BMI in individuals with chronic LBP. Understanding the association between DRA, LBP, and BMI may have important implications for treatment of LBP and for intervention.

Cited by 44 publications

References 37 publications

Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: Prevalence, risk factors and its impact on life

Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: Prevalence, risk factors and its impact on life

Cohort study of the effect of surgical repair of symptomatic diastasis recti abdominis on abdominal trunk function and quality of life

Women’s experiences of living with increased inter-recti distance after childbirth: an interview study

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