Clinical Research Directory

Effect of Exercise on the Width and Stiffness of the Linea Alba in Postpartum Women With Diastasis

his study aims to evaluate the effect of an exercise program in postpartum women with diastasis recti, defined as an inter-rectus distance greater than 2 cm at any of three ultrasound measurement points . Participants will be divided into two groups: an intervention group that will follow a 6-week exercise program and a control group that will receive usual care. Ultrasound assessment of the linea alba will be performed before the intervention and after 6 weeks. The main outcomes will be inter-rectus distance and the stiffness of the linea alba measured using shear wave elastography, along with obstetric and personal clinical variables. Participants will be recruited from primary care centers in the Community of Madrid through midwives during postpartum consultations.

Rehabilitation of Abdominal Diastasis After Childbirth: Trunk and Inspiratory Muscle Training

Diastasis Recti Abdominis (DRA) is the separation of the rectus muscles caused by stretching and thinning of the linea alba during pregnancy and childbirth. It's a common condition, affecting 66-100% of women post-birth and can persist for many years, leading to abdominal protrusion, discomfort, and aesthetic concerns. It might also contribute to back pain, urinary issues, and reduced abdominal strength, impacting quality of life. Recent guidelines propose that conservative management, such as rehabilitation interventions, should be prioritized for DRA. However, there is a lack of consensus among researchers regarding the most effective exercise regimen, resulting in diverse rehabilitation programs. Recent evidence advocates not only for closing the gap but also for achieving optimal function. Current studies often neglect to address functional rehabilitation, underscoring the necessity for robust clinical trials, which is the primary focus of this study. Additionally, although breathing exercises are commonly prescribed for DRA, the precise role of the diaphragm, the primary respiratory muscle, in rehabilitation hasn't been fully examined. The diaphragm forms the upper boundary of the abdominal cavity and plays a key role in the stability of the trunk, working together with the abdominal and pelvic floor muscles. A recent study found reduced diaphragm excursion in postpartum women with lumbopelvic pain during a low postural demanding task, while previous studies suggest that diaphragm training could alleviate such symptoms influencing factors such as diaphragm thickness and excursion, which may be linked to improved trunk stability. Hence, training the diaphragm and accessory inspiratory muscles through Inspiratory Muscle Training (IMT) could potentially play a crucial role in managing DRA. In summary, the goal of this study is to develop and assess a comprehensive rehabilitation program aimed at effectively reducing DRA and addressing associated dysfunctions. The program will integrate evidence-based rehabilitation interventions, such as trunk stabilization exercises and IMT, targeting all related dysfunctions caused by DRA, and introducing a novel therapeutic protocol not previously implemented. The study will take the form of a prospective, randomized controlled trial (RCT).