Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial.
Sandra L Gluppe, Gunvor Hilde, Merete K Tennfjord and 2 others
PMID 29351646WHAT IT FOUND
A postpartum program combining pelvic floor, abdominal, back, arm, thigh, stretching and relaxation plus daily home pelvic floor training did not reduce diastasis recti prevalence compared with instruction and written information only at 6 or 12 months.
Key findings
01There were no significant between-group differences in DRA prevalence at 6 months (RR 0.99) or at 12 months (RR 1.04).
02Both the exercise and control groups had significant within-group reductions in DRA prevalence at 6 and 12 months postpartum.
03The program combined weekly supervised pelvic floor, abdominal, back, arm, thigh, stretching and relaxation training with daily home pelvic floor training, so the contribution of any single component cannot be separated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
No specific power calculation was done for DRA as the outcome. This was a secondary analysis; the parent trial was powered for urinary incontinence. DRA was assessed by finger-width palpation, which has moderate interrater reliability and could not report continuous interrectus distance. Most women had mild or moderate DRA, so a treatment effect in severe DRA might not have been captured. The intervention included several exercise components, so the effect of any single component cannot be identified. The control group had higher education and more married or cohabitating women, and the exercise group had heavier infants at birth. The sample was limited to women able to understand Scandinavian languages. Missing values were handled by last observation carried forward.
Declared interests
The study was funded by the Norwegian Research Council, which had no role in the conduct of the study.
The easy way to misread this
Do not read the within-group reduction in both arms as proof that the exercise program closed DRA. The between-group difference was null at 6 and 12 months.