Shohaimi Suhaila, Husain Nik Rosmawati Nik, Zaki Faizah Mohd, Atan Ixora Kamisan
Physiotherapy Unit, Medical Rehabilitation Services Department, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Korean J Fam Med. 2023 Mar;44(2):102-108. doi: 10.4082/kjfm.22.0035. Epub 2023 Mar 20.
Diastasis rectus abdominis (DRA) involves the separation of the midline abdominal muscles and linea alba and affects more than half of postpartum women. This study aimed to assess the effect of a split tummy exercise program (STEP) on DRA closure in postpartum mothers.
A randomized controlled trial was conducted from 2008 to 2020 at the Obstetrics and Gynaecology Clinic of the Universiti Kebangsaan Malaysia Medical Centre. Primigravida mothers diagnosed with DRA were selected and randomly assigned to the intervention (n=21) or control (n=20) group. The intervention group underwent a home-based STEP consisting of three phases of nine abdominal exercises. DRA size was assessed at baseline and at 8 weeks postpartum using two-dimensional ultrasound.
The mean age of the participants was 28 years (standard deviation, 3.6), with the majority of Malay ethnicity (87.8%) and working mothers (78%). After 8 weeks, the intervention group showed a significant reduction in DRA size of up to 27% (mean difference, 6.17 mm; 95% confidence interval, 3.7-8.7; P<0.001). No significant intergroup DRA changes were observed after 8 weeks of follow-up.
Early postpartum screening for DRA should be advocated to allow early STEP intervention to ensure favorable outcomes. STEP intervention is an effective postnatal training program for managing DRA.
腹直肌分离症（DRA）涉及腹中线肌肉和白线分离，影响超过半数的产后女性。本研究旨在评估一种分阶段腹部锻炼计划（STEP）对产后母亲腹直肌分离闭合的效果。
2008年至2020年在马来西亚国民大学医学中心妇产科诊所进行了一项随机对照试验。选取诊断为腹直肌分离症的初产妇，随机分为干预组（n = 21）或对照组（n = 20）。干预组接受一项居家的分阶段腹部锻炼计划，该计划由九个腹部练习的三个阶段组成。在基线和产后8周使用二维超声评估腹直肌分离的大小。
参与者的平均年龄为28岁（标准差3.6），大多数为马来族（87.8%）且为在职母亲（78%）。8周后，干预组腹直肌分离大小显著减小，降幅高达27%（平均差值6.17毫米；95%置信区间3.7 - 8.7；P < 0.001）。随访8周后，未观察到组间腹直肌分离有显著变化。
应提倡产后早期筛查腹直肌分离症，以便早期进行分阶段腹部锻炼计划干预，确保取得良好效果。分阶段腹部锻炼计划干预是管理腹直肌分离症的一项有效的产后训练计划。
