What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis.

The seven trials used different ways to measure the gap (ultrasound, caliper, finger-width palpation), at different locations along the linea alba, and with different cut-off values for what counts as diastasis, making direct comparison difficult. Four of the seven studies did not include a minimal intervention (education-only) control group, so it is unclear whether the gap would have narrowed on its own over the study period. Interventions combined multiple exercises and modalities (abdominal binding, electrical stimulation, prone lying, education, taping), so the effect of any single exercise cannot be separated from the rest of the programme. All included studies enrolled women with mild or moderate diastasis only; no data on severe cases (over 5 cm). Sample sizes were very small in several studies (9, 30, 32 women), and two were pilot trials. Only English, German, and Scandinavian language studies were included. Common methodological flaws included lack of concealed allocation, inability to blind participants and therapists, and absence of intention-to-treat analysis in some trials.

No conflicts of interest declared.

Do not read the 0.63 cm gap reduction as proof that transversus abdominis training treats diastasis recti. It comes from two pilot studies with 30 total participants, was rated very low quality, and the authors state it should not be used in clinical practice guidelines. The interventions in the positive trials also included other exercises and modalities, so the effect cannot be attributed to one specific movement.