Department of Ultrasonography, Huashan Hospital, Fudan University, Shanghai, China.
Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China.
J Back Musculoskelet Rehabil. 2024;37(6):1641-1647. doi: 10.3233/BMR-240074.
Morphological changes in the abdominal wall muscle in diastasis recti abdominis (DRA) patients with low back pain (LBP) symptoms and whether there is a wider interrectus distance (IRD) remain unclear.
The aim of this study was to determine the correlation between DRA severity and LBP and the morphological differences in abdominal wall muscles between patients who presented with symptoms of LBP and those who were asymptomatic.
A total of 57 postpartum DRA patients were enrolled, including 21 without LBP, 36 with LBP, and 30 healthy nulliparous women. The numerical rating scale (NRS) was used to evaluate the degree of LBP. The IRD and muscle thickness of the abdominal muscles were measured via an ultrasonography device at the end of a natural breathing cycle.
The abdominal muscles of the rectus abdominis (RA), external oblique muscle (EO), and transversus abdominis (TrA) in the DRA patients were significantly thinner than those in the control group (p< 0.05), whereas the difference in the internal oblique muscle (IO) was not significant (p> 0.05). There were no statistically significant differences in abdominal muscle thickness or the IRD regardless of whether the patients with DRA had LBP symptoms, with similar findings between the NRS score and DRA severity (P> 0.05).
In DRA patients within one year postpartum, no significant difference was found in the severity of DRA or abdominal muscles, regardless of whether they were complicated by LBP symptoms. Shortening the IRD alone may not be beneficial for improving LBP symptoms in DRA patients. The relationship between DRA and LBP and the role of the abdominal muscles in postpartum LBP should be interpreted with caution.
患有腹直肌分离症(DRA)且伴有下腰痛(LBP)症状的患者腹壁肌肉的形态变化,以及是否存在更宽的腹直肌间距离(IRD)尚不清楚。
本研究旨在确定 DRA 严重程度与 LBP 之间的相关性,以及有 LBP 症状和无症状的 DRA 患者腹壁肌肉的形态差异。
共纳入 57 例产后 DRA 患者,其中 21 例无 LBP,36 例有 LBP,30 例健康未产妇。采用数字评分量表(NRS)评估 LBP 程度。在自然呼吸周期结束时,使用超声设备测量 IRD 和腹壁肌肉的厚度。
DRA 患者的腹直肌(RA)、腹外斜肌(EO)和腹横肌(TrA)的肌肉厚度明显比对照组薄(p<0.05),而内斜肌(IO)的差异无统计学意义(p>0.05)。无论 DRA 患者是否有 LBP 症状,其腹壁肌肉厚度或 IRD 均无统计学差异,且 NRS 评分与 DRA 严重程度之间也无差异(P>0.05)。
在产后 1 年内的 DRA 患者中,无论是否伴有 LBP 症状,DRA 严重程度或腹壁肌肉均无明显差异。单纯缩短 IRD 可能对改善 DRA 患者的 LBP 症状无益。DRA 与 LBP 之间的关系以及腹部肌肉在产后 LBP 中的作用应谨慎解释。