de Oliveira Laís Campos, de Almeida Laura Isabel Martins, Lucio Maria Clara Fagundes, Campos Júnior Jorge Furtado de, de Oliveira Raphael Gonçalves
Postgraduate Program in Human Movement Sciences, Universidade Estadual do Norte do Paraná, Jacarezinho, Paraná, Brazil.
Medicine (Baltimore). 2025 Jun 6;104(23):e42723. doi: 10.1097/MD.0000000000042723.
Verify the effects of conservative approaches for treating diastasis recti abdominis in postpartum women.
PubMed, Embase, CENTRAL, CINAHL, SportDiscus, LILACS, and PEDro were searched, until March 15, 2024. The methodological quality of randomized clinical trials (RCTs) was assessed using the PEDro scale. Meta-analyses were conducted using the mean difference (MD) between groups for interrectus distance (IRD) in millimeters (mm).
After screening, 34 RCTs were included in the systematic review, of which 21 presented a low risk of bias. Very low certainty evidence demonstrated significant effects for IRD reduction in favor of abdominal exercises versus no intervention (MD = -6.82 mm) and for abdominal exercises plus multi-interventions versus abdominal exercises only (MD = -3.56 mm). Subgroup analyses demonstrated that significant IRD reduction occurs only with isotonic abdominal exercises (MD = -3.78 mm) and that the best co-intervention with abdominal exercises is electrical stimulation (MD = -4.43 mm).
Isotonic abdominal exercises, especially when combined with electrical stimulation, represent the best conservative treatment option for improving postpartum diastasis recti abdominis. However, due to the very low certainty of the evidence, these results should be interpreted with caution, and further well-designed RCTs with high methodological quality are needed to confirm these findings.
验证保守治疗方法对产后腹直肌分离女性的疗效。
检索了PubMed、Embase、CENTRAL、CINAHL、SportDiscus、LILACS和PEDro数据库，检索截至2024年3月15日的文献。使用PEDro量表评估随机临床试验（RCT）的方法学质量。采用组间平均差（MD）对腹直肌间距（IRD，单位为毫米）进行Meta分析。
筛选后，34项RCT纳入系统评价，其中21项偏倚风险较低。极低确定性证据表明，与无干预相比，腹部锻炼对减少IRD有显著效果（MD = -6.82毫米），与仅进行腹部锻炼相比，腹部锻炼加多种干预措施对减少IRD有显著效果（MD = -3.56毫米）。亚组分析表明，只有等张腹部锻炼能显著减少IRD（MD = -3.78毫米），与腹部锻炼最佳的联合干预措施是电刺激（MD = -4.43毫米）。
等张腹部锻炼，尤其是与电刺激相结合时，是改善产后腹直肌分离的最佳保守治疗选择。然而，由于证据的确定性非常低，这些结果应谨慎解读，需要进一步开展方法学质量高的精心设计的RCT来证实这些发现。
