Association of Diastasis Recti with Lumbopelvic Pain in Postpartum; A Cross-sectional Study

Diastasis Recti & Lumbopelvic Pain in Postpartum

Authors

  • Fareeha Jabeen Physio Care Clinic, Gujrat, Pakistan
  • Nouman Abid Lifeline Health Care and Pain Center, Lahore, Pakistan
  • Asna Waseem Central Park Medical College
  • Usman Ghani Lifeline Health Care and Pain Center, Lahore, Pakistan
  • Asha Javaid Social Security Hospital, Lahore, Pakistan
  • Maida Chaudhary Hamza Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.55735/hjprs.v3i3.87

Keywords:

diastasis recti, lumbo-pelvic pain, postpartum

Abstract

Background: Diastasis recti abdominis is an impairment that is characterized by the separation of the rectus abdominis muscles along the linea alba. There is an increased distance between the two recti muscles which is termed “inter-recti distance”, that might exist congenitally, but usually develops during pregnancy and in the initial postpartum period. Objective: To determine the association between diastasis rectus abdominis and lumbopelvic pain in postpartum females. Methods: In this cross-sectional study, the data was collected from various public and private hospitals in Lahore, Pakistan for a six-month duration. Convenient sampling was used to include 97 postpartum females aged between 25 and 35 years. Those postpartum females were excluded who had any history of auto-immune disease, cerebral disease or any spinal issue. After getting their consent, the postpartum females were asked about their age and mode of delivery and they filled self-structured assessment questionnaire The body mass index of patients was calculated and Pearson’s correlation was applied to find out the association between lumbopelvic pain and diastasis recti abdominis. Results: The occurrence of diastasis recti abdominis was 81(83.5%) out of 97 postpartum females and their inter-rectus distance was greater than 16mm at 2cm below the umbilicus. A significant association was found between lumbopelvic pain and diastasis recti abdominis in postpartum females (p<0.05). Conclusion: This study concluded that diastasis recti abdominis is significantly associated with lumbopelvic pain in postpartum females. Out of 97 postpartum females who were included in this study 81 were reported to have diastasis recti abdominis and out of these 81 postpartum females 47 were reported to have lumbopelvic pain in their postpartum period.

References

Kaufmann R, Reiner C, Dietz U, Clavien P, Vonlanthen R, Käser S. Normal width of the linea alba, prevalence, and risk factors for diastasis recti abdominis in adults, a cross-sectional study. Hernia 2022; 26(2): 609-18.

https://doi.org/10.1007/s10029-021-02493-7

Gow J-B, Christensen A. Medical Terminology: Active Learning Through Case Studies: Jones & Bartlett Learning; 2022.

https://books.google.com/books?hl=en&lr=&id=QZhREAAAQBAJ&oi=fnd&pg=PP1&dq=Gow+JB,+Christensen+A.+Medical+Terminology:+Active+Learning+Through+Case+Studies:+Jones+%26+Bartlett+Learning%3B+2022.&ots=rKvESkyWCT&sig=QaoStCgl1YFwu2PI536CYvS6itg

Preethi PA, Vijayalakshmi K, Moses S, Mathipriya K, Pavithralochani V. Effects of Kinesiotaping along with abdomen and pelvic floor exercise on diastasis recti abdominis for postpartum women in normal delivery versus LSCS. Biomedicine 2022; 42(1): 143-7.

https://doi.org/10.51248/.v42i1.823

Spitznagle TM, Leong FC, Van Dillen LR. Prevalence of diastasis recti abdominis in a urogynecological patient population. International urogynecology journal 2007; 18(3): 321-8.

DOI 10.1007/s00192-006-0143-5

Lockwood T. Rectus muscle diastasis in males: primary indication for endoscopically assisted abdominoplasty. Plastic and reconstructive surgery 1998; 101(6): 1685-91; discussion 92.

DOI: 10.1097/00006534-199805000-00042

Palanivelu C, Rangarajan M, Jategaonkar P, Amar V, Gokul K, Srikanth B. Laparoscopic repair of diastasis recti using the ‘Venetian blinds’ technique of plication with prosthetic reinforcement: a retrospective study. Hernia 2009; 13(3): 287-92.

DOI 10.1007/s10029-008-0464-z

Da Mota PGF, Pascoal AGBA, Carita AIAD, Bø K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual therapy 2015; 20(1): 200-5.

https://doi.org/10.1016/j.math.2014.09.002

Candido G, Lo T, Janssen P. Risk factors for diastasis of the recti abdominis. Journal-association of chartered physiotherapists in womens health 2005; 97: 49.

https://www.sciencedirect.com/science/article/pii/S1356689X14001817

Turan V, Colluoglu C, Turkuilmaz E, Korucuoglu U. Prevalence of diastasis recti abdominis in the population of young multiparous adults in Turkey. Ginekologia polska 2011; 82(11).

https://journals.viamedica.pl/ginekologia_polska/article/view/46265

Rett M, Braga M, Bernardes N, Andrade S. Prevalence of diastasis of the rectus abdominis muscles immediately postpartum: comparison between primiparae and multiparae. Brazilian Journal of Physical Therapy 2009; 13: 275-80.

https://doi.org/10.1590/S1413-35552009005000037

Chiarello CM, Falzone LA, McCaslin KE, Patel MN, Ulery KR. The effects of an exercise program on diastasis recti abdominis in pregnant women. Journal of women’s health physical therapy 2005; 29(1): 11-6.

https://journals.lww.com/jwhpt/Fulltext/2005/29010/The_Effects_of_an_Exercise_Program_on_Diastasis.3.aspx?bid=AMCampaignWKHJ&casa_token=l4bWSh_u_i4AAAAA:llGleGb_q-j3y0b6OEQ3WfC1t8oq1T8ICUltjDqy74nmX5wybn81qHrDeVbNJoQ2lJuITc8yb0onxptBv3_KQuXq5geY

Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British journal of sports medicine 2016; 50(17): 1092-6.

http://dx.doi.org/10.1136/bjsports-2016-096065

Montwieler J. Essential Exercises for the Childbearing Years: A Guide to Health and Comfort Before and After Your Baby is Born. Oxford University Press; 1978.

https://doi.org/10.1093/ptj/58.8.1020

Chang SR, Chao YM, Kenney NJ. I am a woman and I’m pregnant: body image of women in Taiwan during the third trimester of pregnancy. Birth 2006; 33(2): 147-53.

https://doi.org/10.1111/j.0730-7659.2006.00087.x

Crommert ME, Flink I, Gustavsson C. Predictors of disability attributed to symptoms of increased interrecti distance in women after childbirth: an observational study. Physical Therapy 2021; 101(6): pzab064.

https://doi.org/10.1093/ptj/pzab064

Anwar A, Sharif F, Saleem Z. Predictors of disability attributed to symptoms of increased interrecti distance in pregnant and postpartum women with diastasis rectus abdominis. The Healer Journal of Physiotherapy and Rehabilitation Sciences 2022; 2(1): 88-96.

https://doi.org/10.55735/thjprs.v2i1.46

Kassam F, Laghaei Farimani P, Mashayekhi M, Doroudi M. A Guide to the Anatomy of the Anterior Abdominal Wall: Examining the Impact of Virtual Dissection on the Learner's Experience. The FASEB Journal 2021; 35.

https://doi.org/10.1096/fasebj.2021.35.S1.04750

Gluppe SB, Engh ME, Bø K. Immediate effect of abdominal and pelvic floor muscle exercises on interrecti distance in women with diastasis recti abdominis who were parous. Physical Therapy 2020; 100(8): 1372-83.

https://doi.org/10.1093/ptj/pzaa070

Lee DG, Lee L-J, McLaughlin L. Stability, continence and breathing: the role of fascia following pregnancy and delivery. Journal of bodywork and movement therapies 2008; 12(4): 333-48.

https://www.sciencedirect.com/science/article/pii/S1360859208000880

Gilleard WL, Brown JMM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. Physical therapy 1996; 76(7): 750-62.

https://academic.oup.com/ptj/article-abstract/76/7/750/2633092

Eriksson Crommert M, Petrov Fieril K, Gustavsson C. Women’s experiences of living with increased inter-recti distance after childbirth: an interview study. BMC women's health 2020; 20(1): 1-10.

https://doi.org/10.1186/s12905-020-01123-1

Iqbal MH, Hussain T, Khalid F, Malik MA, Ashraf I, Nazir T. Diastasis Recti Abdominis and Its Associated Risk Factors in Postpartum Women. Pakistan Armed Forces Medical Journal 2020; (5): 1535.

https://www.researchgate.net/profile/Fariha-Khalid/publication/345686545_DIASTASIS_RECTI_ABDOMINIS_AND_ITS_ASSOCIATED_RISK_FACTORS_IN_POSTPARTUM_WOMEN/links/602d02e4299bf1cc26cf9d50/DIASTASIS-RECTI-ABDOMINIS-AND-ITS-ASSOCIATED-RISK-FACTORS-IN-POSTPARTUM-WOMEN.pdf

Gustavsson C, Eriksson-Crommert M. Physiotherapists’ and midwives’ views of increased inter recti abdominis distance and its management in women after childbirth. BMC women's health 2020; 20(1): 1-9.

https://doi.org/10.1186/s12905-020-00907-9

ASIF JS. Effect of abdominal physiotherapy in reduction of inter recti distance in postpartum females. 2021.

DOI: https://doi.org/10.53350/pjmhs211561446

Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. International journal of epidemiology 2014; 43(3): 655-65.

https://doi.org/10.1093/ije/dyu058

Parker MA, Millar LA, Dugan SA. Diastasis rectus abdominis and lumbo-pelvic pain and dysfunction-are they related? Journal of women’s health physical therapy 2009; 33(2): 15-22.

https://journals.lww.com/jwhpt/Fulltext/2009/33020/Diastasis_Rectus_Abdominis_and_Lumbo_Pelvic_Pain.3.aspx?casa_token=iUR6tRM93tIAAAAA:JcEQYxcJnnDNa5aPEVN0-040fQfWWDpOOX6v2dSSFyAdfaIaQHfCyvIXbhT0GuEaGLBRKbnjG796y_7o0o0u1nuO56IE

Dalal K, Kaur A, Mitra M. Correlation between diastasis rectus abdominis and lumbopelvic pain and dysfunction. Indian Journal of Physiotherapy and Occupational Therapy 2014; 8(1): 210.

https://search.proquest.com/openview/1f967123bdb19d88e45cf52f36c400a1/1?pq-origsite=gscholar&cbl=2028906

Deering RE, Senefeld J, Pashibin T, Neumann DA, Cruz M, Hunter SK. Fatigability of the lumbopelvic stabilizing muscles in women 8 and 26 weeks postpartum. Journal of women's health physical therapy 2018; 42(3): 128.

doi: 10.1097/JWH.0000000000000109

Aabroo S, Riaz H, Saeed A, Ashraf F. Frequency of diastasis recti and lumbopelvic pain during pregnancy and factors associated with diastasis recti. Rawal Medical Journal 2020; 45(3): 682-.

https://www.rmj.org.pk/fulltext/27-1540376487.pdf

Thornton SL, Thornton SJ. Management of gross divarication of the recti abdominis in pregnancy and labour. Physiotherapy 1993; 79(7): 457-8. https://doi.org/10.1016/S0031-9406(10)60221-0.

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Published

2023-04-09

How to Cite

Jabeen, F. ., Abid, N. ., Waseem, A. ., Ghani, U. ., Javaid, A. ., & Chaudhary, M. . (2023). Association of Diastasis Recti with Lumbopelvic Pain in Postpartum; A Cross-sectional Study: Diastasis Recti & Lumbopelvic Pain in Postpartum. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 3(3), 407–414. https://doi.org/10.55735/hjprs.v3i3.87

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