Ramírez-Jiménez Miriam, Alburquerque-Sendín Francisco, Garrido-Castro Juan Luis, Rodrigues-de-Souza Daiana
Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain.
Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.
Physiother Theory Pract. 2023 Jan;39(1):49-60. doi: 10.1080/09593985.2021.2004630. Epub 2021 Nov 15.
Abdominal diastasis (AD) is highly prevalent at post-partum. Although several conservative approaches have been proposed, an effective and protocolized treatment is lacking for this condition.
To identify modifications of inter-rectus abdominis distance (IRAD), trunk circumferences and mechanical properties of the AD, transversus abdominis and the pelvic floor (PF) muscles, after the application of hypopressive exercises (HE) and at a two-month follow-up in postpartum AD.
Twelve volunteers with post-partum AD followed a four-week (three times a week) tailored program of HE. The main outcome was the IRAD, assessed at four specific supraumbilical points (3, 6, 9, and 12 cm). Abdominal circumference and respiratory expansion were measured at three different locations (axillar, xiphoid, and umbilical), and the mechanical properties of abdomino-pelvic tissues were also assessed using tonometry (MyotonPRO). Four evaluations were performed for all outcomes: at baseline, post-intervention, at a 1-month follow-up, and at a 2-month follow-up.
The IRAD of participants was reduced ( < .05), furthermore, some participants displayed no AD after the intervention period. In addition, the abdominal circumference increased, mainly at follow-up, whereas the thoracic respiratory expansion decreased a median of 2 cm. The tension and stiffness of the LA decreased, when assessed at 3 and 6 cm supraumbilical. Finally, the tension and elasticity of TA/IO and of the PF, and also the elasticity of the PF decreased after the intervention period. No complaints were identified in relation to the HE program or assessments.
A program of HE showed positive results for the reduction of post-partum AD. Different study designs should be performed to better explain the effects of HE for AD.
腹直肌分离(AD)在产后极为常见。尽管已提出多种保守治疗方法,但针对该病症仍缺乏有效的规范化治疗方案。
确定在产后腹直肌分离患者中应用减压运动(HE)后以及在两个月随访时,腹直肌间距(IRAD)、躯干周长以及腹直肌分离、腹横肌和盆底(PF)肌肉的力学特性的变化。
12名产后腹直肌分离志愿者参加了为期四周(每周三次)的个性化减压运动计划。主要观察指标是在四个特定的脐上点(3、6、9和12厘米)评估的IRAD。在三个不同位置(腋窝、剑突和脐部)测量腹围和呼吸扩张,并使用张力计(MyotonPRO)评估腹盆腔组织的力学特性。对所有观察指标进行了四次评估:基线时、干预后、1个月随访时和2个月随访时。
参与者的IRAD降低(<0.05),此外,一些参与者在干预期后未出现腹直肌分离。此外,腹围增加,主要在随访时增加,而胸廓呼吸扩张中位数减少了2厘米。在脐上3厘米和6厘米处评估时,白线(LA)的张力和硬度降低。最后,干预期后腹横肌/腹内斜肌(TA/IO)和盆底肌的张力和弹性以及盆底肌的弹性降低。未发现与减压运动计划或评估相关的不良反应。
减压运动计划对减少产后腹直肌分离显示出积极效果。应采用不同的研究设计来更好地解释减压运动对腹直肌分离的影响。