Effect of exercise on the inter-rectus distance in pregnant women with diastasis recti abdominis: an experimental longitudinal study

Objective To investigate the effect of acute contraction of the pelvic floor muscles (PFM) and abdominal exercises on the inter-rectus distance (IRD) compared to resting values, and differences between gestation weeks 27 and 37, in pregnant women with diastasis recti abdominis (DRA). Design Experimental longitudinal design. Setting Physiotherapy clinic, primary health care. Participants Thirty-eight pregnant women with DRA >= 2.8 cm. Interventions Two-dimensional ultrasound images of IRD 2 cm above and below the umbilicus were taken at rest and during PFM and abdominal exercises at gestation week 27 and 37. Repeated measures analyses of variance (ANOVAs) with post hoc tests was performed for each exercise for both locations and timepoints. Main outcome measures Change in IRD. Results There was a mean increase of the IRD from rest during a PFM contraction (2 mm, 95% CI: 2, 3), drawing-in (4 mm, 95% CI: 3, 5) and a combination of these (5 mm, 95% CI: 4, 6) There was a mean decrease of the IRD from rest during the headlift (-3 mm, 95% CI: -4, -2), the curl-up (-3 mm, 95% CI: -4, -2) and the diagonal curl up (-4 mm, 95% CI: -5, -3). Effect of time from gestation week 27-37 was a mean increase of 8 mm (95% CI: 6, 9). Conclusion Pelvic floor and drawing-in exercise increased the IRD, whilst headlift, curl up and diagonal curl up decreased the IRD in pregnant women with DRA at gestation week 27 and 37. Contribution of the paper center dot This is the first study to investigate the acute effect of exercise on IRD in pregnant women with DRA. center dot Diagonal curl-up, headlift and curl-up reduced the IRD in pregnant women with DRA at both gestation week 27 and 37. The drawing-in exercise and a PFM contraction increased the IRD at the same timepoints. center dot As exercise involving the rectus abdominis muscle decrease the inter-rectus distance in pregnant women, clinicians should reconsider advising against such exercises. (c) 2023 The Author(s). Published by Elsevier Ltd on behalf of Chartered Society of Physiotherapy. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).