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Wang L, Yun T, Zhang D, Zhong J, Yi D, Fu W, Li M, Zhang Y, Wang Y. A prospective study of two-dimensional ultrasonography combined with shear wave elastography for pregnancy-related diastasis recti abdominis. Front Physiol 2024; 15:1382982. [PMID: 38860113 PMCID: PMC11163132 DOI: 10.3389/fphys.2024.1382982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
Objectives To compare the inter-rectus distance (IRD), rectus abdominis thickness (RAT), and stiffness in women during pregnancy and postpartum and identify the risk and protective factors affecting diastasis recti abdominis (DRA). Materials and methods A total of 171 pregnant women who volunteered to participate in this study were recruited. Using an ultrasonographic diagnostic instrument with shear wave elastography function, IRD, RAT and the Young's modulus of the rectus abdominis muscles were measured at 12 weeks, 37 weeks of pregnancy, and 6 weeks postpartum. Results The IRD at 37 weeks was significantly higher than that at 12 weeks and then decreased at 6 weeks postpartum, but it was still higher than that at 12 weeks (p < 0.001). RAT and Young's modulus decreased significantly at 37 weeks compared with those at 12 weeks and then recovered at 6 weeks postpartum, but they were lower than those at 12 weeks (p < 0.001). IRD at 12 weeks was significantly higher in multiparae than in primiparae (p < 0.001). Moreover, positive correlation between the RAT and Young's modulus of rectus abdominis muscles at 12 and 37 weeks of gestation and 6 weeks postpartum (p < 0.001) was observed. Multiple linear regression analysis showed that the regression equation was significant (f = 24.856, p < 001). Conclusion Our study identified differences in IRD, thickness and stiffness of the rectus abdominis muscle between early and advanced pregnancy and the postpartum period. The risk and protective factors of DRA may guide pregnant women's protection and treatment.
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Affiliation(s)
- Li Wang
- Graduate School of the PLA General Hospital, Beijing, China
- Department of Ultrasound, The Six Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ting Yun
- Department of Ultrasound, The Six Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dong Zhang
- Orthopedics Department, The Six Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianrong Zhong
- Department of Gynaecology and Obstetrics, The Six Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dan Yi
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wanxi Fu
- Department of Ultrasound, The Six Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Molin Li
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yunshan Zhang
- Department of Ultrasound, The Six Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yuexiang Wang
- Department of Ultrasound, The First Medical Center of Chinese PLA General Hospital, Beijing, China
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Marander V, Råheim M, Haukenes I, Theodorsen NM. Mothers' experiences living with diastasis recti abdominis - an interview study. BMC Womens Health 2024; 24:292. [PMID: 38760781 PMCID: PMC11100213 DOI: 10.1186/s12905-024-03131-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Diastasis recti abdominis (DRA) is a common postpartum condition. Knowledge is scarce on how mothers perceive living with DRA. The interaction between healthcare providers and patients plays a significant role in shaping the healthcare service experience. Women suffering from typical women's diseases tend to experience not being taken seriously or listened to when seeking healthcare. The aim of this study was to explore mothers' experiences living with DRA. METHODS Semi-structured individual interviews were conducted with six Norwegian mothers, age 32-41, presenting with a clinically significant DRA. Topics discussed were how the condition is experienced, how it affects different aspects of day-to-day life and experiences with healthcare services. The data was analyzed using systematic text condensation. RESULTS DRA had an impact on everyday life among the mothers included in this study. Three major themes emerged: (I) The path to obtaining knowledge and understanding of DRA, (II) DRA - intertwined with health issues and physical limitations and (III) A changed belly - on self-image & social interactions. The mothers experienced uncertainties and frustration when trying to learn about DRA. The limited knowledge of the condition made it hard to differentiate if the experienced symptoms were caused by presence of DRA or from other health issues. Several mothers felt misunderstood. CONCLUSION DRA is a multifaceted condition affecting many aspects of day-to-day life in various dimensions, like physical, emotional, and social. This study contributes to a wider understanding of living with DRA, which might guide healthcare professionals in providing support for mothers with this condition.
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Affiliation(s)
- Viktoria Marander
- Department of Global Public Health and Primary Care, University of Bergen, Alrek helseklynge, blokk D, Årstadveien 17, Bergen, 5009, Norway
| | - Målfrid Råheim
- Department of Global Public Health and Primary Care, University of Bergen, Alrek helseklynge, blokk D, Årstadveien 17, Bergen, 5009, Norway
| | - Inger Haukenes
- Department of Global Public Health and Primary Care, University of Bergen, Alrek helseklynge, blokk D, Årstadveien 17, Bergen, 5009, Norway
- Research Unit for General Practice, NORCE - Norwegian Research Centre, Bergen, Norway
| | - Nina-Margrethe Theodorsen
- Department of Global Public Health and Primary Care, University of Bergen, Alrek helseklynge, blokk D, Årstadveien 17, Bergen, 5009, Norway.
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Christopher SM, Donnelly G, Brockwell E, Bo K, Davenport MH, De Vivo M, Dufour S, Forner L, Mills H, Moore IS, Olson A, Deering RE. Clinical and exercise professional opinion of return-to-running readiness after childbirth: an international Delphi study and consensus statement. Br J Sports Med 2024; 58:299-312. [PMID: 38148108 DOI: 10.1136/bjsports-2023-107489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 12/28/2023]
Abstract
Female athletes have identified a lack of guidance as a barrier to successfully returning to running postpartum, and existing guidelines are vague. Our aim was to define the current practice of determining postpartum run-readiness through a consensus survey of international clinicians and exercise professionals in postpartum exercise to assist clinicians and inform sport policy changes.A three-round Delphi approach was used to gain international consensus from clinicians and exercise professionals on run-readiness postpartum. Professionals who work with postpartum runners participated in an online survey to answer open-ended questions about the following postpartum return-to-running topics: definitions (runner and postpartum), key biopsychosocial milestones that runners need to meet, recommended screening, timeline to initiate running, support items, education topics and factors that contribute to advising against running. Consensus was defined as ≥75% participant agreement.One hundred and eighteen professionals participated in round I, 107 participated in round II (response rate 90.6%) and 95 participated in round III (response rate 80.5%). Responses indicated that, following a minimum 3-week period of rest and recovery, an individualised timeline and gradual return to running progression can be considered. Screening for medical and psychological concerns, current physical capacity, and prior training history is recommended prior to a return to running.This study proposes recommendations for the initial guidance on return-to-running postpartum, framed in the context of current research and consensus from professionals. Future research is needed to strengthen and validate specific recommendations and develop guidelines for best practice when returning-to-running after childbirth.
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Affiliation(s)
- Shefali Mathur Christopher
- Department of Rehabilitation Sciences, Doctor of Physical Therapy, Tufts University, Seattle, Washington, USA
- Elon University, Elon, North Carolina, USA
| | - Gráinne Donnelly
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Kari Bo
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Marlize De Vivo
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, UK
- Active Pregnancy Foundation, None, UK
| | - Sinead Dufour
- The World of my Baby (WOMB), Faculty of Health Science, McMaster University, Hamilton, Ontario, Canada
| | - Lori Forner
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Hayley Mills
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, UK
| | - Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Rita E Deering
- Department of Physical Therapy, Carroll University, Waukesha, Wisconsin, USA
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Canton SA. "Slim-Mesh" Technique for Diastasis Recti Abdominis, Including Obesity-Related Cases. JSLS 2024; 28:e2024.00003. [PMID: 38562947 PMCID: PMC10984376 DOI: 10.4293/jsls.2024.00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Background and Objective We operated on a series of mostly obese patients with diastasis recti abdominis using the "Slim-Mesh" technique to repair/reinforce the diastasis and linea alba/recti muscles without plicating and traumatizing them. Additional objectives were to decrease operation time and intra- and postoperative complications. Methods We considered T1 cases diastasis after pregnancy and T2 cases obesity (BMI ≥ 30 mg/kg2); D1, D2, and D3 when the diastasis measured 2-3, 3-5, and ≥ 5 cm, respectively; H0 and H1 without and concomitant umbilical and/or epigastric hernia, respectively. At our Department, between May 2010 and November 2022, 47 patients with diastasis recti were operated on with the "Slim-Mesh" technique to reinforce/repair the traumatized linea alba/recti muscles, without plicating them. This was a prospective (83%)-retrospective study. Results We studied 23 males and 24 females. Mean age and BMI was 58 years and 29 kg/m2, respectively. Groups D1, D2, and D3 comprised 6, 23 and 18 patients, respectively; groups T1, T2, H0 and H1 comprised 22, 25, 13 and 34 patients, respectively. Mean operation time for all cases was 100 minutes. Mean length of hospital stay was 2.3 days and follow-up time was 5 years. We had 6 late postoperative complications: 3 hernia recurrences and 3 trocar site hernias. Conclusion Considering the lack of agreement on the best surgery for diastasis recti abdominis repair, in our experience the "Slim-Mesh" technique is a valid, safe and easy-to-reproduce way to save, repair and reinforce linea alba/recti muscles in diastasis recti patients, including the obese population (53%).
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Affiliation(s)
- Silvio Alen Canton
- Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padua, Italy. (Dr. Canton)
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Fitzpatrick SE, Foley K, Crittenden T, Watson D, Dean NR. Australian women's experiences of post-partum rectus diastasis: A qualitative study. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241233123. [PMID: 38577913 PMCID: PMC10998484 DOI: 10.1177/17455057241233123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/23/2023] [Accepted: 01/25/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Post-partum rectus diastasis, or the separation of the abdominal muscles after pregnancy, occurs in conjunction with physical symptoms and impaired quality of life. In Australia, health funding for surgery to treat diastasis was ceased in 2016, but reinstated in mid-2022, providing a unique context from which women's experiences of this condition can be analysed. OBJECTIVES The objective is to examine the experiences of Australian women with post-partum rectus diastasis. DESIGN This is an interview-style study with qualitative content analysis. METHODS Women diagnosed with rectus diastasis were recruited to complete a baseline questionnaire (n = 45). Twenty-three responded to invitation for one-on-one interview via Zoom® between November 2021 and May 2022. Interviews were recorded, transcribed, and analysed using qualitative content analysis to identify key themes. RESULTS Eighteen women had undergone caesarean section and eight had twins. Thirteen had private health insurance. Women were most often diagnosed by a physiotherapist (n = 10). Key themes identified included changed physical appearance and function; issues with self-esteem and intimacy; barriers to treatment; lack of recognition as a medical condition; and overall frustration. The impact of rectus diastasis extended beyond physical and psychological symptoms to affect women's social functioning, child rearing, and return to work. There was a complex interaction between healthcare providers' knowledge of rectus the removal of funding for surgical treatment, and limitations of conservative therapy, with women's lived experiences and symptoms. The lack of an established medical definition also influenced the experiences of these women and their engagement with treatment. CONCLUSION This study contextualizes women's experience of post-partum rectus diastasis with respect to the unique landscape of Australia's healthcare economy and provides evidence of women's absorption of health policy surrounding this condition. Our qualitative analysis provides critical knowledge for future quantitative studies, the results of which in combination could advance the definition of rectus diastasis and inform healthcare policy surrounding treatment.
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Affiliation(s)
- Siobhan Elizabeth Fitzpatrick
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Adelaide, SA, Australia
| | - Kristen Foley
- Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, SA, Australia
| | - Tamara Crittenden
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Adelaide, SA, Australia
| | - David Watson
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Surgery, Flinders Medical Centre, Adelaide, SA, Australia
| | - Nicola R Dean
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Adelaide, SA, Australia
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Vicente-Campos V, Fuentes-Aparicio L, Rejano-Campo M. [Evaluation of the physical and psychosocial consequences of the diastasis of the rectus abdominis and its interference in health: A mixed study]. Rehabilitacion (Madr) 2023; 57:100744. [PMID: 35760642 DOI: 10.1016/j.rh.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/11/2022] [Accepted: 03/16/2022] [Indexed: 04/12/2023]
Abstract
INTRODUCTION Diastasis rectus abdominis (DRA) is defined as the separation of the rectus abdominis along the linea alba. This condition can occur in both sexes, being frequent in women during pregnancy and pospartum. There is little evidence on the consequences of DRA on the quality of life of women. OBJECTIVE The analysis of the perception of the symptoms of and its repercussion on a physical, psychological and social level in women affected by this condition. PATIENTS AND METHODS Observational study through a semi-structured online survey, composed of 30 closed questions and 2 open ones. The inclusion criteria were adult Spanish-speaking women who had given birth and who presented abdominal diástasis. The data were analyzed quantitatively and the qualitative information was obtained through a content analysis of the open questions. RESULTS 319 women with DRA were included. The results showed a negative effect of DRA on quality of life, functional capacities, and urogynecological and digestive health. Likewise, a negative impact was evidenced at an emotional level, on body image and poor self-perceived health. CONCLUSION DRA has a negative impact on women's health. Women with DRA present an impairment of the quality of life and functional capacities, an alteration in body image, feelings of abandonment by health institutions, shame, sadness, powerlessness, lack of self-esteem, resignation and social pressure.
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Affiliation(s)
| | - L Fuentes-Aparicio
- Grupo investigación Multiespecialidad (PTinMOTION), Departamento de Fisioterapia, Universidad de Valencia, Valencia, España.
| | - M Rejano-Campo
- Montse Rejano Fisioterapeuta, El Puertillo, Las Palmas, España
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Gluppe S, Ellström Engh M, Bø K. Primiparous women's knowledge of diastasis recti abdominis, concerns about abdominal appearance, treatments, and perceived abdominal muscle strength 6-8 months postpartum. A cross sectional comparison study. BMC Womens Health 2022; 22:428. [PMID: 36324105 PMCID: PMC9632123 DOI: 10.1186/s12905-022-02009-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Diastasis recti abdominis (DRA) is a prevalent condition in the postpartum period. To date, there is scant knowledge on how DRA influences physical, mental, and emotional health. This study investigates primiparous women`s knowledge about DRA, concerns about abdominal appearance, and perceived abdominal muscle strength, comparing women with and without reported DRA. METHODS This was a cross-sectional comparison study. Data were collected by a web-based questionnaire, mainly through social media in Norway. To be included in the study women had to be primiparous 6-8 months postpartum. The questionnaire contained questions regarding women`s knowledge about DRA, perceived protrusion, received treatment, concerns with abdominal appearance and muscle strength. Abdominal body image was measured through the shape concern questions from The Eating Disorder Examination questionnaire (EDE-Q 6.0). Demographic and other descriptive variables are presented as means with standard deviations (SD) or as frequencies with percentages. Chi-square test of independence and independent sample t-tests were used to compare differences between women with and without abdominal protrusion for categorical and continuous variables, respectively. RESULTS Our sample consisted of 460 women. Knowledge about DRA was reported by 415/440 (94.3%) women. A total of 73.3% reported to have been worried during pregnancy about abdominal appearance postpartum. Mean degree of concern about present abdominal appearance was 5.5/10 (SD 2.4). Almost 80% experienced weaker abdominal muscles than pre-pregnancy. Ninety-six women (20.9%) reported a protrusion along the midline of their abdomen. Significantly more women with protrusion reported weaker abdominal muscles than women without protrusion. The most frequent treatment women with protrusion reported were exercises for the abdominal muscles (92.6%). Mean score on the EDE-Q, shape concern questions, was higher in women with reported protrusion (mean score: 2.37 (SD 1.6) than women without protrusion (mean score: 2.14 (SD 1.4), p = 0.175. CONCLUSION Primiparous women are concerned about abdominal appearance both during pregnancy and after birth. Those reporting abdominal protrusion are less satisfied with their abdominal appearance and they report weaker abdominal muscles than women without protrusion. This study may contribute to improved knowledge about women`s health concerns, and assessment of DRA should be part of routine follow-up of postpartum women.
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Affiliation(s)
- Sandra Gluppe
- grid.412285.80000 0000 8567 2092Department of Sports Medicine, Norwegian School of Sports Sciences, Sognsveien 220, 0806 Oslo, Norway
| | - Marie Ellström Engh
- grid.411279.80000 0000 9637 455XDepartment of Obstetrics and Gynaecology, Akershus University Hospital, Sykehusveien 25, 1478 Lørenskog, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kari Bø
- grid.412285.80000 0000 8567 2092Department of Sports Medicine, Norwegian School of Sports Sciences, Sognsveien 220, 0806 Oslo, Norway ,grid.411279.80000 0000 9637 455XDepartment of Obstetrics and Gynaecology, Akershus University Hospital, Sykehusveien 25, 1478 Lørenskog, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, University of Oslo, Oslo, Norway
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Efficacy and Challenges in the Treatment of Diastasis Recti Abdominis—A Scoping Review on the Current Trends and Future Perspectives. Diagnostics (Basel) 2022; 12:diagnostics12092044. [PMID: 36140446 PMCID: PMC9498119 DOI: 10.3390/diagnostics12092044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/02/2022] [Accepted: 08/19/2022] [Indexed: 12/03/2022] Open
Abstract
Diastasis recti abdominis (DRA) is more prevalent in women during pregnancy and postpartum. However, there is a lack of awareness regarding this condition among women. The prevalence of DRA is high in late pregnancy and reduces during postpartum. The purpose of this study is to provide an overview of the treatment strategies for DRA and to discuss the significance of the technology towards better diagnosis and treatment. This work investigated 77 research articles published in the recognized research databases. The study aims to analyze the diagnostic and treatment procedures and the role of technology within them. The management strategy for DRA can either be conservative or surgical. Exercise therapy has been shown to improve functional impairments. These exercises focus on recruiting the abdominal muscles. Electromyography and Ultrasound imaging have been employed as useful tools in assessing the abdominal muscles effectively. This study has examined the treatment methods for DRA to obtain a better understanding of the existing methods. Further investigation and experimentation into therapeutic exercises is strongly recommended to identify the best set of exercises for a faster resolution. Further studies regarding the role of technology to assess therapeutic exercises would be worthwhile.
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Automatic Assessment of Abdominal Exercises for the Treatment of Diastasis Recti Abdominis Using Electromyography and Machine Learning. Symmetry (Basel) 2022. [DOI: 10.3390/sym14081654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Diastasis Recti Abdominis (DRA) is a medical condition in which the two sides of the rectus abdominis muscle are separated by at least 2.7 cm. This happens when the collagen sheath that exists between the rectus muscles stretches beyond a certain limit. The recti muscles generally separate and move apart in pregnant women due to the development of fetus in the womb. In some cases, this intramuscular gap will not be closed on its own, leading to DRA. The primary treatment procedures of DRA involve different therapeutic exercises to reduce the inter-recti distance. However, it is tedious for the physiotherapists to constantly monitor the patients and ensure that the exercises are being done correctly. The objective of this research is to analyze the correctness of such performed exercises using electromyogram (EMG) signals and machine learning. To the best of our knowledge, this is the first work reporting the objective evaluation of rehabilitation exercises for DRA. Experimental studies indicate that the surface EMG signals were effective in classifying the correctly and incorrectly performed movements. An extensive analysis was carried out with different machine learning models for classification. It was inferred that the RUSBoosted Ensembled classifier was effective in differentiating these movements with an accuracy of 92.3%.
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Śmietański M, Śmietańska IA, Zamkowski M. Post-partum abdominal wall insufficiency syndrome (PPAWIS): lessons learned from a single surgeon's experience based on 200 cases. BMC Surg 2022; 22:305. [PMID: 35941642 PMCID: PMC9358894 DOI: 10.1186/s12893-022-01757-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background Post-partum abdominal wall insufficiency (PPAWI) with rectus diastasis is present in over 30% of women after pregnancy. Little is known about how PPAWI affects the social, sexual life and self-esteem of patients. This study was designed to evaluate the safety of onlay mesh combined with abdominoplasty and its impact on the well-being of the patients. Method Two hundred patients with PPAWI underwent surgery with onlay mesh and abdominoplasty. The safety of the procedure was assessed by postoperative complications, time of hospitalization and time of drainage. Before the operation and 6 months later, a questionnaire asking about the patient’s sexual and social life and the presence of back pain was completed. The final cosmetic effect was assessed separately. Results The onlay procedure with abdominoplasty was found to be safe and fast. The mean operation time was 82 min, and the drainage time was 2.1 days. In this group < 2% postoperative complications were noted. There were no recurrences within the 6 month. Significant improvements in social and sexual life and the level of self-esteem were noted. Back pain was relieved or minimalized in all patients. The final cosmetic effect was insufficient for 2 patients (1%). Conclusion PPAWI can be treated safely with onlay mesh and abdominoplasty. The patients’ symptoms were strongly correlated with the morphological status of the front abdominal wall and improved after the procedure. Describing the psychological and social consequences of PPAWI should lead the surgical societies to propose a definition of a new disease called PPAWIS (post-partum abdominal wall insufficiency syndrome). Supplementary Information The online version contains supplementary material available at 10.1186/s12893-022-01757-y.
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Affiliation(s)
- Maciej Śmietański
- 2nd Department of Radiology, Medical University of Gdansk, Dębinki 7, 80-952, Gdańsk, Poland. .,Swissmed Hospital in Gdansk, Department of Surgery and Hernia Centre, Gdańsk, Wileńska 44, 80-215, Poland.
| | - Irmina Anna Śmietańska
- Department of Anaesthesiology and Intensive Care, Medical University of Gdansk, Gdańsk, Dębinki 7, 80-952, Poland
| | - Mateusz Zamkowski
- Swissmed Hospital in Gdansk, Department of Surgery and Hernia Centre, Gdańsk, Wileńska 44, 80-215, Poland
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Li Q, Lei S, Liu Y, Liu Q, Chen Y, Lin X, Zhang X. Effectiveness of Yoga on the Interrectus Distance in Early Postpartum Women: A High-Frequency Ultrasound Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8908095. [PMID: 35647191 PMCID: PMC9142290 DOI: 10.1155/2022/8908095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/13/2022] [Accepted: 04/23/2022] [Indexed: 11/17/2022]
Abstract
To investigate the effects of ultrasonic evaluation of a progressive yoga exercise program on reducing the inter-recti distance (IRD) among women in the early postpartum period. Postpartum women (n = 116), free of obstetric complications and in recovery following vaginal delivery between weeks 1 and 12, were recruited. Participants were randomly assigned to the control and yoga exercise group in the pre- and post-intervention design. The control group received no treatment, while the yoga exercise group participated in a guided 12-week progressive yoga exercise program started at postpartum week 1. The IRD was examined using high-frequency ultrasound at postpartum weeks 6 and 12. The results showed that the supraumbilical, umbilical, and subumbilical IRD were significantly decreased in the yoga exercise group after the 12-week progressive yoga exercise intervention compared with the first (week 6) and second (week 12) measurements. The differences in IRD at supraumbilical, umbilical, and subumbilical intervals between weeks 6 and 12 significantly increased in the yoga exercise group. Progressive yoga exercises are effective program that reduce IRD among women in the early postpartum period through ultrasound evaluation. In conclusion, women should advocate combined yoga exercise in the early postpartum days following a supervised program.
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Affiliation(s)
- Qunfeng Li
- Guangdong Polytechnic of Science and Technology, Zhuhai, 510640 Guangdong, China
| | - Siman Lei
- Faculty of Education, University of Macau, Taipa, 999078 Macao SAR, China
| | - Yanhong Liu
- Zhuhai Women and Children's Hospital, Zhuhai, 519001 Guangdong, China
| | - Qiongzhu Liu
- Zhuhai Women and Children's Hospital, Zhuhai, 519001 Guangdong, China
| | - Ying Chen
- Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 Guangdong, China
| | - Xin Lin
- Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 Guangdong, China
| | - Xinling Zhang
- Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630 Guangdong, China
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Olsson A, Kiwanuka O, Wilhelmsson S, Sandblom G, Stackelberg O. Surgical repair of diastasis recti abdominis provides long-term improvement of abdominal core function and quality of life: a 3-year follow-up. BJS Open 2021; 5:6369782. [PMID: 34518875 PMCID: PMC8438255 DOI: 10.1093/bjsopen/zrab085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/03/2021] [Indexed: 11/12/2022] Open
Abstract
Background Diastasis recti abdominis (DRA) is a condition affecting many post-partum women. The aim of this study was to evaluate long-term results of surgical repair of DRA in a cohort of post-partum women. Methods Sixty post-partum women with DRA and training-resistant core dysfunctions were included. Surgical repair was performed with suture plication of the linea alba. Abdominal core function was evaluated with the abdominal trunk function protocol (ATFP) including a self-report questionnaire and seven functional tests. Urinary incontinence and quality of life were evaluated with the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the SF-36 questionnaire. Follow-up was performed at 1 and 3 years after surgery. Results Response rate at the 3-year follow-up was 86.7 per cent for the disability rating index (DRI) questionnaire; and 71.7 per cent for the ATFP, UDI-6, IIQ-7 and SF-36 questionnaires. All DRI parameters were improved (P < 0.001) after 3 years of follow-up compared with preoperative values. The functional tests in the ATFP showed an improvement in core muscle strength and stability (P < 0.001), back muscle strength (P < 0.001) and abdominal muscle strength (P = 0.002) compared to preoperative values as well as an improvement of core muscle strength and stability compared with the 1-year follow-up values (P = 0.003). UDI-6 and IIQ-7 results were improved (P < 0.001 and P = 0.004) compared with preoperative values and showed consistent values compared with the 1-year follow-up (P = 0.09 and P = 1.0). Quality of life measured with SF-36 was improved compared with preoperative values and showed consistent values compared with the 1-year follow-up. Conclusion The functional improvement of surgical reconstruction of the DRA persisted for 3 years in this series of post-partum women with DRA.
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Affiliation(s)
- Anders Olsson
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Olivia Kiwanuka
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Sofia Wilhelmsson
- Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
| | - Gabriel Sandblom
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - Otto Stackelberg
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,Department of Surgery, Södersjukhuset, Stockholm, Sweden.,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Izydorczyk B, Walenista W, Kamionka A, Lizińczyk S, Ptak M. Connections Between Perceived Social Support and the Body Image in the Group of Women With Diastasis Recti Abdominis. Front Psychol 2021; 12:707775. [PMID: 34434150 PMCID: PMC8381222 DOI: 10.3389/fpsyg.2021.707775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The psychological features of the body image and the role of perceived social support for women with diastasis recti abdominis (DRAM) is significant for the treatment of this group of patients, but it is difficult to identify research on this topic. We aimed to search for similarities and differences between postpartum women with DRAM in terms of their psychological features of the body image and perceived social support from the partner, family and friends. Methods: Three hundred forty-five Polish women with DRAM were asked to fill the The Multidimensional Body-Self Relations Questionnaire (MBSRQ), The Multidimensional Scale of Perceived Social Support (MSPSS) and The Drawing Self-Assessment Sheet. Data analysis included the stepwise regression analysis and k-cluster analysis. Results: We identified several predictors in the group of women with DRAM. Social support of partner, family, and friends are the predictors of self-assessment of general body appearance. Social support of family is a predictor of self-assessment of the health of the body. Social support of friends is a predictor of self-esteem of weight and fear of gaining weight. Moreover, three clusters of women with DRAM were found. Type 1-women with DRAM with one child and low self-esteem of the general appearance of the body, low self-esteem of health condition of the body, high self-esteem of weight, and fear of weight gain, and low level of social support; Type 2-women with DRAM with three or more children and low self-esteem of the general appearance of the body, low self-esteem of health condition of the body, high self-esteem of weight and fear of weight gain, and high level of social support; and Type 3-women with DRAM with two children and high self-esteem for the general appearance of the body, high level of self-esteem for health of the body, low self-esteem of weight and fear of weight gain, and high levels of social support. Conclusions: Social support is a predictor of body image in women with DRAM, but there are other factors that influence body acceptance more in this group of women. Furthermore the three clusters featured in the study may help in treating women with DRAM.
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Affiliation(s)
- Bernadetta Izydorczyk
- Faculty of Management and Social Communication, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Wiktoria Walenista
- Faculty of Management and Social Communication, Institute of Applied Psychology, Jagiellonian University, Kraków, Poland
| | - Agata Kamionka
- Department of Psychology, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Sebastian Lizińczyk
- Katowice Faculty of Psychology, SWPS University of Social Sciences and Humanities, Katowice, Poland
| | - Magdalena Ptak
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
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