Comparative Efficacy of Abdominal Exercises and Abdominal Binding on Diastasis Recti Abdominis Reduction in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

IF 1.8 Q3 REHABILITATION

Physiotherapy Research International Pub Date : 2025-04-01 DOI:10.1002/pri.70038

Abdullah, Khawaja Abdul Rehman, Bilal Ahmad, Muhammad Khubaib Arshad, Humza Saeed, Mahnoor Asghar Keen, Amna Anwar, Noor Ul Ain Saleem, Umm E Salma Shabbar Banatwala, Zara Bilal, Maryam Shahzad, Pakeeza Shakoor, Muhammad Ahsen Niazi

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引用次数: 0

Abstract

Background and purpose: Diastasis Recti Abdominis (DRA) is a separation of the rectus abdominis muscles which often results from pregnancy. This meta-analysis aims to identify the most effective non-surgical treatment to reduce post-partum DRA.

Methods: A comprehensive search was performed on electronic databases including PubMed, Cochrane, and Embase databases for RCTs involving abdominal or pelvic muscle exercises, and abdominal binding for DRA Reduction. Primary outcomes included inter-recti distance (IRD) Resolution, Oswestry Disability Index (ODI) score, and Pelvic Floor Disability Index (PFDI) score. ROB 2.0 tool was used for the risk of bias assessment of RCTs. Meta-analysis was performed using Review Manager version 5.4. Sensitivity analysis was conducted to determine the influence of studies on the overall results. Meta regression was performed using R version 4.4 to identify the sources of heterogeneity.

Results: Thirteen RCTs were included in the analysis. Abdominal exercise significantly reduced IRD below the umbilicus compared with abdominal binding (Mean difference [MD] = -0.31, 95% CI: -0.53 to -0.10, p = 0.004) but was ineffective for IRD resolution ≥ 2 cm above the umbilicus (MD = 0.22, 95% CI: -1.43 to 1.88, p = 0.79). Compared with no intervention, abdominal exercise significantly reduced IRD below the umbilicus (MD = -0.31, 95% CI: -0.53 to -0.10, p = 0.004) but was ineffective in IRD resolution ≥ 2 cm above the umbilicus (MD = 0.11, 95% CI: -0.38 to 0.59, p = 0.67). No significant reduction was found in the ODI score (MD = -5.57, 95% CI: -19.31 to 8.17, p = 0.43) and PFDI score (MD = -12.99, 95% CI: -43.49 to 17.51, p = 0.04).

Discussion: Abdominal exercises reduce IRD below the umbilicus more effectively than binding and no intervention, but their effectiveness above the umbilicus is unclear. ODI and PFDI showed no significant improvement. Further research with standardized criteria and diverse population is needed to clarify the efficacy of these treatments for diastasis recti.

查看原文本刊更多论文

腹部运动和腹部捆绑对产后妇女减少腹直肌转移的比较疗效：随机对照试验的系统评价和荟萃分析。

背景和目的：腹直肌分离（DRA）是一种经常由妊娠引起的腹直肌分离。本荟萃分析旨在确定减少产后DRA最有效的非手术治疗方法。方法：在PubMed、Cochrane和Embase等电子数据库中全面检索涉及腹部或骨盆肌肉锻炼和腹部结合DRA降低的rct。主要结局包括直肌间距离（IRD）分辨率、Oswestry残疾指数（ODI）评分和盆底残疾指数（PFDI）评分。rct偏倚风险评估采用ROB 2.0工具。meta分析使用Review Manager版本5.4进行。进行敏感性分析以确定研究对总体结果的影响。采用R版本4.4进行Meta回归，以确定异质性的来源。结果：13项rct纳入分析。与腹部捆绑相比，腹部运动显著降低了脐以下的IRD（平均差异[MD] = -0.31, 95% CI: -0.53至-0.10,p = 0.004），但对脐以上≥2 cm的IRD分辨率无效（MD = 0.22, 95% CI: -1.43至1.88,p = 0.79）。与未干预相比，腹部运动显著降低了脐以下的IRD (MD = -0.31, 95% CI: -0.53至-0.10,p = 0.004)，但对脐以上≥2 cm的IRD分辨率无效（MD = 0.11, 95% CI: -0.38至0.59,p = 0.67）。ODI评分（MD = -5.57, 95% CI: -19.31 ~ 8.17, p = 0.43）和PFDI评分（MD = -12.99, 95% CI: -43.49 ~ 17.51, p = 0.04）均无显著降低。讨论：腹部运动比捆绑和无干预更有效地减少脐以下的IRD，但其在脐以上的有效性尚不清楚。ODI和PFDI无明显改善。需要进一步研究标准化标准和多样化的人群，以明确这些治疗方法对直肠转移的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy Research International REHABILITATION-

CiteScore

3.30

自引率

5.90%

发文量

期刊介绍： Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.