Effect of progressive prone plank exercise program on diastasis of rectus abdominis muscle in postpartum women: A randomized controlled trial

Abstract

Diastasis of Rectus Abdominis (DRA) muscle is a concerning health issue that commonly affects female within pregnancy and postpartum time, persistent lower back pain and pelvic instability are common consequences to DRA. Thus, this study was conducted to examine the effect of progressive prone plank exercises on narrowing the inter-Rectus distance (IRD) in postpartum women diagnosed with (DRA). A prospective, randomized, single-blind, controlled trial was conducted at the Faculty of Physical Therapy Clinic of Beni-Suef University. Fifty postpartum women presented with (DRA) of at least 2 finger widths assigned into 2 equal groups (A&B). A Toshiba Xario100, 8-12 MHz ultrasonography was used to accurately measure IRD before and after 8 weeks of the exercise program. Group (A), received progressive prone plank exercise program and advice relevant to DRA as well as wore abdominal binder, while group (B) continued their ordinary lifestyle after receiving advice and wearing abdominal binder as group (A).The study results revealed a statistical significant decrease within each group and between groups in IRD (p < .05) above and below the umbilicus both at rest and during Rectus Abdominis (RA) contraction, with a significantly narrower IRD in favoured of participants of group (A) (p < .05). To sum it up, progressive prone plank exercise program is very effective in decreasing IRD in postpartum women presented with DRA.

Use of Exercise in the Management of Postpartum Diastasis Recti: A Systematic Review

“…Studies tested the effects of abdominal draw-in/static abdominal contraction exercises,18,22–24,26 bridging,19,29,30 head lift,18,25,28 4-point arm lift,19 forms of controlled leg raise/lift,19,23,25,27,29 pelvic clock rotations,18 pelvic floor muscle exercises/Kegels,20,22,26,31 plank,22,23,25,26,29–31 posterior pelvic tilt,18,26,27,31 postural positioning/correction,23,25 reverse trunk twist/u-seat/Russian twist,26,28,31 sit-ups/reverse sit-ups,22,26–28 and squats 18,28. Adjunct modalities included abdominal binding22,23 controlled breathing/exhalation,19,25,26,28 education,19,21,30 electrical stimulation,27,28 and taping 24…”

“…Among the 9 randomized controlled studies (OCEBM level II evidence), 4 were rated as good quality,22–24,26 3 fair,21,28,31 and 2 poor25,30 (see Supplemental Digital Content Table 4, available at: http://links.lww.com/JWHPT/A68). Comprehensively, given the nature of exercise as an intervention, none of the studies blinded participants to treatment group.…”

“…Comprehensively, given the nature of exercise as an intervention, none of the studies blinded participants to treatment group. It was unclear whether outcomes assessors were blinded to group placement in 3 studies 21,25,30. Just 1 study22 reported that its sample size was sufficiently large to detect between-group differences with at least 80% power.…”

“…Four of the 9 randomized controlled studies21,24,25,30 reporting 14 measurement conditions were included in the meta-analysis (see Supplemental Digital Content Table 7, available at: http://links.lww.com/JWHPT/A71). Studies were not included in the meta-analysis if the control group included exercise as an intervention26,28,31 or if the study did not report means and standard deviations 22,23.…”

“…Several studies19,21,22,26,30,31 implemented deep core protocols to treat DRA, and 3 of these studies22,26,31 incorporated pelvic floor muscle strengthening/retraining into the core protocol. All but one19 of these studies was a randomized controlled trial.…”