Vita Fabio, Donati Danilo, Amouso Vincenza, Stella Salvatore Massimo, Fantini Marta, Tedeschi Roberto, Miceli Marco, Galletti Stefano, Faldini Cesare
IRCCS Istituto Ortopedico Rizzoli, 1st Orthopaedics and Traumatology Clinic, Bologna, University of Bologna, Bologna, Italy.
Physical Therapy and Rehabilitation Unit, Policlinico di Modena, Modena, Italy.
J Sport Rehabil. 2025 Jan 17;34(6):601-608. doi: 10.1123/jsr.2024-0252. Print 2025 Aug 1.
Diastasis rectus abdominis is a condition in which the rectus abdominis muscles separate and move laterally, causing stretching of the linea alba tissue with weakness of the abdominal wall. Although it can lead to hernia of the abdominal viscera, diastasis rectus abdominis is not a hernia in itself. This condition is common among women during pregnancy and the postpartum period and can significantly affect their quality of life and their return to sports activity. Unfortunately, information on the incidence, risk factors, prevention, and treatment of diastasis rectus abdominis are limited.
We conducted a pilot prospective observational study on 37 patients who practiced sports at high levels (at least 3 times a week with amateur/competitive competitions) who underwent ultrasound measurements of the distance between the rectus abdominis muscles at the level of the xiphoid process, supraumbilical, umbilical, and subumbilical at time (T0), after 2 months from the rehabilitation protocol (T1), and then after 4 months of rehabilitation protocol (T2) from approximately 3 months after giving birth, and we saw an early return to sport.
Our data analysis reveals that there is an initial decrease in diastasis during the first 2 months with 3 weekly physiotherapy activity sessions in all 4 measurements. One session takes place on site with physiotherapists, while the other 2 are carried out at home using the rehabilitation protocol provided by the medical staff. At the 4-month follow-up, the improvement was similar to the previous follow-up.
Of the 37 women analyzed, 6 were referred to the surgeon; 2 for hernias and 4 for diastases greater than 4 cm. The remaining women benefited from a conservative approach. Patients undergoing the rehabilitation protocol showed improvements in all 4 measures, as well as their early return to sport.
腹直肌分离是一种腹直肌肌肉分开并向外侧移动的情况,会导致白线组织拉伸以及腹壁薄弱。虽然腹直肌分离可导致腹腔脏器疝,但它本身并非疝。这种情况在孕期和产后女性中很常见,会显著影响她们的生活质量以及恢复运动活动的能力。不幸的是,关于腹直肌分离的发病率、危险因素、预防和治疗的信息有限。
我们对37名高水平运动者(每周至少进行3次业余/竞技比赛)进行了一项前瞻性观察性试点研究,这些人在产后约3个月时,于时间点(T0)、康复方案实施2个月后(T1)以及康复方案实施4个月后(T2),接受了剑突水平、脐上、脐部和脐下水平腹直肌肌肉间距的超声测量,且我们观察到她们较早恢复了运动。
我们的数据分析显示,在所有4项测量中,通过每周3次物理治疗活动,在最初的2个月内腹直肌分离情况出现了初步改善。其中1次治疗由物理治疗师在现场进行,另外2次在家中按照医务人员提供的康复方案进行。在4个月的随访中,改善情况与之前的随访相似。
在分析的37名女性中,6人被转诊给外科医生;2人因疝,4人因腹直肌分离大于4厘米。其余女性受益于保守治疗方法。接受康复方案的患者在所有4项测量中均有改善,并且较早恢复了运动。