School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada.
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
Phys Ther. 2018 Mar 1;98(3):182-190. doi: 10.1093/ptj/pzx117.
Diastasis recti abdominis (DrA) is associated with negative body image, musculoskeletal pain and dysfunction, and perhaps urogynecological complaints. The severity of DrA has traditionally been determined by measuring the interrectus distance (IRD); however, the relationship between IRD and symptoms in women with DrA is unclear.
The objective of the study was to investigate the relationship between IRD and symptom severity in women with DrA in the early postpartum period.
This study used a cross-sectional design.
Thirty-two women with DrA were assessed at 3 weeks postpartum. The IRD was measured using ultrasound imaging. Symptom severity was assessed using the Multidimensional Body-Self Relations Questionnaire subscales (body image), visual analog scales (abdominal, low back, and pelvic pain intensity), the Modified Oswestry Index (disability due to low back pain), and the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire (urogynecological dysfunction). Spearman correlation coefficients (ρ) between IRD and each outcome were calculated and tested using 1-tailed significance (adjusted α = .009).
The group median IRD was 2.97 cm (interquartile range = 1.65 cm), with the largest IRD in the sample being 7.97 cm. The IRD was significantly correlated with worst abdominal pain in the last 24 hours (ρ = 0.45, P = .005) and with overall body image (ρ = -0.44, P = .006) but not with the other outcomes.
Women in the sample were primiparous, were in the early (3 weeks) postpartum period, had relatively low body mass indexes (mean = 25.0 kg/m2) considering that they had recently given birth, were all breast-feeding, and had a narrow age range (27-35 years old). These factors limited the generalizability of our results to all women with DrA.
This preliminary work suggests that, in the early postpartum period, IRD as a measure of DrA severity is meaningful for body image.
腹直肌分离（DrA）与负面身体形象、肌肉骨骼疼痛和功能障碍，以及可能的尿生殖系统抱怨有关。DrA 的严重程度传统上是通过测量腹直肌间距离（IRD）来确定的；然而，在产后早期患有 DrA 的女性中，IRD 与症状之间的关系尚不清楚。
本研究旨在探讨产后早期 DrA 女性的 IRD 与症状严重程度的关系。
本研究采用横断面设计。
32 名 DrA 女性在产后 3 周时进行评估。使用超声成像测量 IRD。使用多维身体-自我关系问卷子量表（身体形象）、视觉模拟量表（腹部、下背部和骨盆疼痛强度）、改良 Oswestry 指数（下背部疼痛引起的残疾）和盆底窘迫量表和盆底冲击问卷（尿生殖系统功能障碍）评估症状严重程度。计算 IRD 与每个结果之间的 Spearman 相关系数（ρ），并使用单侧显著性检验（调整后的α=0.009）进行检验。
该组的中位数 IRD 为 2.97cm（四分位距=1.65cm），样本中最大的 IRD 为 7.97cm。IRD 与过去 24 小时内最严重的腹痛（ρ=0.45，P=0.005）和整体身体形象（ρ=-0.44，P=0.006）显著相关，但与其他结果无关。
样本中的女性是初产妇，处于产后早期（3 周），考虑到她们最近分娩，身体质量指数（BMI）相对较低（平均=25.0kg/m2），都在母乳喂养，年龄范围较窄（27-35 岁）。这些因素限制了我们的研究结果在所有 DrA 女性中的推广。
这项初步工作表明，在产后早期，IRD 作为 DrA 严重程度的衡量标准，对身体形象具有意义。
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