Association of Diastasis Recti Abdominis with Pelvic Floor Muscle Strenth and Urine Incontinence in Gynecological Population

Authors

  • Abdul Mateen Rise College Lahore https://orcid.org/0009-0006-7615-8789
  • Rukhsar Amanat Al-Shifa Institute of Health Sciences, Narowal
  • Haider Ali Government College University Faisalabad
  • Hurab Khalid Government College University Faisalabad and Paris Saclay University
  • Akram Ali Indus Hospital and Health Network Karachi
  • Ayesha Rehman Lahore Institute of Science and Technology
  • Samia Khaliq Al-Shifa Institute of Health Sciences, Narowal

DOI:

https://doi.org/10.47672/ajhmn.1672

Keywords:

Diastasis Recti Abdominis, Multiparous, Pelvic Floor Muscles Physiotherapy, Pregnancy, Urine Incontinence

Abstract

Purpose: Diastasis recti abdominis (DRA) denotes an anomalous separation of the rectus muscles throughout their longitudinal axis, devoid of fascial irregularities. The current study sought to determine the prevalence of DRA and its potential association with pelvic floor muscular strength and urinary incontinence in the gynaecological population of Faisalabad. This was a cross-sectional study.

Materials and Methods: A Convenient sampling technique was used for collecting data. A sample of 100 females from government hospitals of Faisalabad was taken. Study was conducted in Faisalabad from February 2018 to May 2018. Inclusion criteria of the research was, immediate postpartum ladies, females aged 18 to menopausal age, and females who had normal vaginal birth. Manometric techniques were employed to quantify the strength of the pelvic floor muscles (PFMS), with outcomes represented in cmH2O. The incidence of urinary incontinence (UI) was ascertained by querying patients regarding any manifestations postpartum. The extent of diastasis recti abdominis (DRA) was gauged utilizing fingerbreadth assessments of the rectus abdominis muscles. This particular measurement spanned a distance of 4.5 cm both superior and inferior to the umbilicus, aligned with the linea alba.

Findings: Results were analyzed through SPSS version 26. Diastasis recti abdominis was found to be present in 57% of the females. 7% of the women had very weak pelvic floor muscle, 38% had weak, 50% had moderate strength and 5% had good strength of pelvic floor muscles. Out of 100, urine incontinence was found in 59% females. There was no statistically significant correlation observed between diastasis recti abdominis muscle and either urinary incontinence or pelvic floor muscle strength, with a p-value exceeding 0.05.

Implications to Theory, Practice and Policy: Incorporate routine DRAM screening for postpartum gynecological patients. Educate women about DRAM, its risk factors, and prevention strategies. Promote postpartum exercises and physical therapy to strengthen abdominal muscles and pelvic floor. Provide nutritional counseling to address obesity, a risk factor for DRAM. Implement a multidisciplinary approach involving gynecologists, physiotherapists, and nutritionists. Conduct additional research on the long-term consequences of DRAM and effective interventions. Conduct awareness campaigns targeting both healthcare providers and the public to increase DRAM awareness.

Downloads

Download data is not yet available.

References

Reinpold W, Köckerling F, Bittner R, Conze J, Fortelny R, Koch A, et al. Classification of rectus diastasis"”a proposal by the German Hernia Society (DHG) and the International Endohernia Society (IEHS). Frontiers in Surgery. 2019;6:1.

Akram J, Matzen SH. Rectus abdominis diastasis. Journal of plastic surgery and hand surgery. 2014;48(3):163-9.

Gitta S, Magyar Z, Tardi P, Füge I, Járomi M, Ãcs P, et al. How to treat diastasis recti abdominis with physical therapy: A case report. Journal of Diseases. 2016;3(2):16-20.

Liaw L-J, Hsu M-J, Liao C-F, Liu M-F, Hsu A-T. The relationships between inter-recti distance measured by ultrasound imaging and abdominal muscle function in postpartum women: a 6-month follow-up study. Journal of Orthopaedic & Sports Physical Therapy. 2011;41(6):435-43.

Camp B. Military Fitness Institute. Diastasis Recti: An Overview. 2015.

Doubkova L, Andel R, Palascakova-Springrova I, Kolar P, Kriz J, Kobesova A. Diastasis of rectus abdominis muscles in low back pain patients. Journal of back and musculoskeletal rehabilitation. 2018;31(1):107-12.

Emanuelsson P, Gunnarsson U, Strigård K, Stark B. Early complications, pain, and quality of life after reconstructive surgery for abdominal rectus muscle diastasis: a 3-month follow-up. Journal of plastic, reconstructive & aesthetic surgery. 2014;67(8):1082-8.

Aparicio LF, Rejano-Campo M, Donnelly GM, Vicente-Campos V. Self-reported symptoms in women with diastasis rectus abdominis: a systematic review. Journal of Gynecology Obstetrics and Human Reproduction. 2021;50(7):101995.

Nahabedian MY, editor Management strategies for diastasis recti. Seminars in Plastic Surgery; 2018: Thieme Medical Publishers.

Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. International urogynecology journal. 2017;28:191-213.

Vergeldt TF, Weemhoff M, IntHout J, Kluivers KB. Risk Factors for Pelvic Organ Prolapse and its Recurrence: A Systematic Review. Obstetrical & Gynecological Survey. 2016;71(1):21-2.

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.

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

Khandale SR, Hande D. Effects of abdominal exercises on reduction of diastasis recti in postnatal women. IJHSR. 2016;6(6):182-91.

Sapsford R, Hodges P, Richardson C, Cooper D, Markwell S, Jull G. Co"activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourology and Urodynamics: Official Journal of the International Continence Society. 2001;20(1):31-42.

Parker MA, Millar LA, Dugan SA. Diastasis rectus abdominis and lumbo-pelvic pain and dysfunction-are they related? The Journal of Women's & Pelvic Health Physical Therapy. 2009;33(2):15-22.

Benjamin DR, Frawley HC, Shields N, van de Water AT, Taylor NF. Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review. Physiotherapy. 2019;105(1):24-34.

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.

Angelo PH, Varella LRD, de Oliveira MCE, Matias MGL, de Azevedo MAR, de Almeida LM, et al. A manometry classification to assess pelvic floor muscle function in women. PLoS One. 2017;12(10):e0187045.

Bø K, Hilde G, Tennfjord MK, Sperstad JB, Engh ME. Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: prospective cohort study. Neurourology and urodynamics. 2017;36(3):716-21.

Adkitte R, Yeole U, Gawali P, Gharote G. Prevalence of diastasis of rectus abdominis muscle in immediate post-partum women of urban and rural areas. Eur J Pharm Med Res. 2016;3(5):460-2.

Keshwani N, Mathur S, McLean L. The impact of exercise therapy and abdominal binding in the management of diastasis recti abdominis in the early post-partum period: a pilot randomized controlled trial. Physiotherapy theory and practice. 2021;37(9):1018-33.

Wang Q, Yu X, Chen G, Sun X, Wang J. Does diastasis recti abdominis weaken pelvic floor function? A cross-sectional study. International Urogynecology Journal. 2020;31:277-83.

Downloads

Published

2023-12-07

How to Cite

Mateen , A. ., Amanat , R. ., Ali , H. ., Khalid , H. ., Ali , A. ., Rehman, A. ., & Khaliq, S. . (2023). Association of Diastasis Recti Abdominis with Pelvic Floor Muscle Strenth and Urine Incontinence in Gynecological Population. American Journal of Health, Medicine and Nursing Practice, 9(5), 1–10. https://doi.org/10.47672/ajhmn.1672