Motor Recommended exercise for Diastasis Recti among women after childbirth - Literature review

Efrat Sompolinsky1, Braha Tabi1, Rachel Kafri2, Daniel Moran3, Noa Ben Ami4

1 Physiotherapist, MSc student, Physical Therapy Department, Ariel University, Israel.
2 Dr Kafri, PT, PhD, Physiotherapist for pelvic floor rehabilitation, self-employed. 
3 Prof’ Moran, PhD, Faculty of Health Sciences, Ariel University.
4 Dr Ben Ami, PT, PhD, Physical Therapy Department,  Faculty of Health Sciences, Ariel University
Background: Inter Recti-Distance (IRD) is a separation between the two rectus muscles. If the separation is above 2 cm it is defined as Diastasis Recti (DR). Usually DR is related to pregnancy and in most cases it is due to structural and hormonal changes and uterine growth. To date, the relation between DR and functional problems remains unclear. Nonetheless, women go to physical therapy care due to their concern regarding the structural and cosmetic changes.
Objective: To conduct a review of research that focuses on the effectiveness of physical activity, and on the most effective exercise to treat women with DR. In addition, to find scientific data that can guide physiotherapists regarding the most effective exercise.

Methods: A search was conducted in the relevant databases for articles published between 2007 and 2017. We found eight studies which examined the best exercise for DR.

Results: Most articles investigated the immediate and not the long-term effects of therapy. One of the studies showed that DR has the ability to heal spontaneously, but without  achieving full recovery. Five articles showed that abdominal curls significantly decrease the IRD. Two of them showed that abdominal curls have advantage over other exercises that involve Transverse Abdominis muscle, and another one showed that abdominal curls have advantages over the use of a corset. One research found no long-term impact of pelvic floor muscle exercises on DR. In addition, a systematic review article was included, according to which exercise reduces the IRD.
Conclusions: There are no data indicating that physical activity of any specific kind improves DR for the long term. Additionally, no data were found to support the assumption that IRD reduction definitively leads to functional and cosmetic improvement for postpartum women. The definition of DR as a pathology, the need to intervene, and the metrics by which to measure the success of the treatment,  - all of these aspects need to be reexamined and explored further.
Key Words: Diastasis recti, Diastasis rectus abdominis, Exercise, Treatment.
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