Bixo L, Sandblom G, Österberg J, Stackelberg O, Bewö K, Olsson A
Department of Surgery, Mora Hospital, Mora, Sweden.
Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.
J Abdom Wall Surg. 2022 Dec 1;1:10909. doi: 10.3389/jaws.2022.10909. eCollection 2022.
The definition and management of Diastasis Recti Abdominis (DRA) is under debate. This study aimed to understand the correlation between the post-partum inter-recti distance (IRD) and functional impairments associated with core instability, with the hypothesis that IRD could serve as a proxy for core instability symptoms and constitute a tool in decision-making for DRA treatment. A cohort of post-partum women with abdominal core instability symptoms combined with DRA were studied. The size of IRD was measured with ultrasonography and cross-sectionally analysed against functional impairments registered with the self-report Disability Rating Index (DRI), which grades the ability to perform 12 different daily activities. A total of 224 women were included in the study. In univariable analysis, IRD was associated with impairment of the activities running ( = 0.007), heavy work ( = 0.036) and exercise/sports ( = 0.047), but not with dressing, walking, sitting for long periods, standing bent over a sink, carrying a suitcase, making a bed, light manual labour or heavy lifting. No significant correlations were seen in the multivariable analysis when adjustments were made for BMI and parity. IRD and post-partum functional impairments had no significant correlation in multivariable analysis. The post-partum core instability condition is complex and probably associated with more factors than solely the IRD. The IRD alone does not seem to be a sufficient proxy for decision-making regarding optimal treatment. A more complete instrument to assess the post-partum abdominal core is warranted.
腹直肌分离（DRA）的定义和管理仍存在争议。本研究旨在了解产后腹直肌间距（IRD）与核心稳定性相关功能障碍之间的相关性，假设IRD可作为核心不稳定症状的替代指标，并构成DRA治疗决策的工具。对一组有腹部核心不稳定症状并伴有DRA的产后女性进行了研究。通过超声测量IRD大小，并针对自我报告的残疾评定指数（DRI）记录的功能障碍进行横断面分析，该指数对进行12种不同日常活动的能力进行分级。共有224名女性纳入研究。在单变量分析中，IRD与跑步活动障碍（P = 0.007）、繁重工作障碍（P = 0.036）和运动/体育活动障碍（P = 0.047）相关，但与穿衣、行走、长时间坐着、弯腰在水槽上站立、提行李箱、铺床、轻度体力劳动或重物搬运无关。在对BMI和产次进行调整的多变量分析中，未发现显著相关性。在多变量分析中，IRD与产后功能障碍无显著相关性。产后核心不稳定状况较为复杂，可能与多种因素相关，而非仅与IRD有关。仅IRD似乎不足以作为最佳治疗决策的替代指标。有必要采用更完整的工具来评估产后腹部核心情况。
