The effect of rectus reapproximation on postoperative muscle strength and core endurance in cesarean section: A prospective case–control study

Abstract

Aim The necessity of the reapproximation technique of the rectus abdominis muscle in the cesarean section (CS) is a controversial issue. We aimed to investigate the effect of the approximation of the rectus abdominis muscle in CS on postoperative pain intensity, muscle strength, and core endurance. Methods Thirty‐eight women whose rectus muscle was reapproximated in CS and 36 women whose muscles were not reapproximated were included in the study. All women were called in for evaluation in the postoperative period twice, in the 8th–10th and 24–26th weeks. While muscle strength was assessed by manual muscle test (MMT), core endurance was assessed by core stability tests [trunk flexion test (TFT), trunk extensor endurance test (TEET), lateral right/left bridge test (LRBT/LLBT)]. The distance between inter‐rectus diastasis (IRD) and rectus abdominis muscle thickness were evaluated by ultrasonography. Results In the first evaluation; in the rectus muscle reapproximation (RMR) group, lower and upper IRD values were less than the control group, while muscle strength, TFT, TEET, LRBT, and LLBT times were higher (p < 0.001, <0.001, 0.014, <0.001, <0.001, 0.002, and <0.001, respectively). In the second evaluation; in the RMR group, lower and upper IRD values were lower than the control group, while upper rectus abdominis muscle thickness, TFT, TEET, and LRBT times were higher (p < 0.001, <0.001, 0.046, <0.001, 0.032, and 0.010, respectively). Conclusion RMR in CS increases muscle strength and core endurance in the early postoperative period. RMR can facilitate the daily work of mother by increasing their physical fitness, especially in the early postoperative period.

Incisional Small-Bowel Strangulation after a Caesarean Section: A Case Report

“…There is a study which claims that rectus muscle re-approximation has no effect on the prevention of diastasis recti [21]. Controversially, a more recent study claims that the re-approximation of rectus muscle increases muscle strength and core endurance in the early postoperative period and has a positive effect on decreasing the inter-rectus diastasis [22]. We were able to find one case report which proposes a new modified undermined suture technique for rectus muscle re-approximation during caesarean delivery.…”

Effects of Running Combined With Muscular Training of the Abdominal Core

“…In this paper, volunteers are divided into two categories. 2 The number of experimental groups (athletes) was 9, and the number of the control group (healthy people) was 9. Subject-specific data are shown in Table 1.…”

Rectus muscle re-approximation in cesarean section — a surgical dilemma: to close or not to close?

“…There are only a few numbers of studies proofing the advantage and disadvantages of RMR [7][8][9][10][11][12][13]. Apart from this, recent studies do not confirm the postoperative effects of RMR [7][8][9][10][11][12][13].…”