Comparison of the Effect of Pilates and Core Stability Exercises on Diastasis Recti and the ‎Structural Component in Abdominis Muscles of Primiparous Mothers

Document Type : Original Article

Authors

Department of Sports Physiology, Faculty of Physical Education and Sports Sciences, Islamic Azad University, Damghan Branch, Damghan, Iran

Abstract

Purpose:
Diastasis recti and structural changes in the abdominal muscles are among the important consequences of C-section delivery. Exercises have been proposed as a safe and pain-free solution to improve these symptoms. Therefore, the purpose of this research was to compare the effects of pilates exercises and core stability on diastasis recti and the structural characteristics of the abdominal muscles in primiparous women.
Methods:
The current research is semi-experimental. A total of 20 primiparous mothers between the ages of 20 and 30 were included in the research based on the inclusion and exclusion criteria. They were randomly divided into two groups of core stability exercises and pilates exercises. In the pre-examination stage, diastasis recti and the thickness of the rectus abdominis and transvers abdominis muscles were evaluated by ultrasound. After that, the subjects of the training groups performed their respective exercises for 8 weeks. The exercises were 3 sessions a week and each session lasted 45 to 60 minutes. After the end of 8 weeks of exercises, all research variables were examined once again in the post-test phase. Two-way analysis of variance method was used to statistically analyze the research findings at a significance level of p≤0.05.
Results:
The results of the two-way analysis of variance test showed that after 8 weeks of exercises, diastasis recti (p=0.001) and the thickness of the rectus abdominis (p=0.001) and transvers abdominis (p=0.021) muscles improved significantly in both training groups. Also, the results showed that in the post-test, there is no significant difference between the average of the study variables in the two training groups (p≥0.05).
Conclusion:
Because pilates and core stability exercises have a significant effect on the recruitment the motor units of the central muscles of the body, they can increase the strength and coordination of the rectus and transverse abdominal muscles and, as a result, create stability in this area. Therefore, they can be suggested as suitable options for improving diastasis recti and the thickness of the abdominal muscles of primiparous women.

Keywords

References

  1. Farazmand T, Fakhr-e-Fatemi Z, Asadi R, Albad S, Lashkardoost H. Factors associated with cesarean delivery compared to normal procedure. Journal of North Khorasan University of Medical Science 2015; 6(4): 851-860.[Persian]
  2. Rahi E, Moheban S, Shabani M, Baneshi M, et al. The Evaluation of the Rate of Cesarean section among Medical Experts Aware of the Side Effects. Journal of Babol University of Medical Sciences 2015; 17(5): 12-18. [Persian]
  3. Mosadeghrad AM, Eslambolchi L. The futurology of normal birth promotion in Iran: letter to editor.  Tehran Univ Med J 2019; 77(4): 272. .[Persian]
  4. Saleh EA, Walton L, Said S, Raigangar V, Kim M. The association between Diastasis recti abdominis and pelvic floor dysfunction, sacroiliac joint dysfunction, and quality of life among postpartum women after Cesarean delivery. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin. 2023; 33.
  5. Izadi F, Khalkhali Zaviyeh M, Akbarzadeh Baghban A. Structural response of abdominal muscles to six weeks of strengthening training in women with diastasis recti. The Iranian Journal of Obstetrics, Gynecology and Infertility 2018; 21(9): 71-82. [Persian]
  6. 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): 200-205.
  7. 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. J Orthop Sports Phys Ther 2011; 41(6): 435-443.
  8. Michalska A, Rokita W, Wolder D, Pogorzelska J, Kaczmarczyk K. Diastasis recti abdominis—a review of treatment methods. Ginekol Pol 2018; 89(2): 97-101.
  9. Ghavipanje V, Rahimi NM, Akhlaghi F. Six weeks effects of dynamic neuromuscular stabilization (DNS) training in obese postpartum women with low back pain: A randomized controlled trial. Biol Res Nurs 2022; 24(1): 106-114. .[Persian]
  10. Davari S, Bagherpoor T, Nemati N. Comparision of the effect of pilates and core stability exercises on diastasis recti, pain, functional disability and quality of life of primiparous mothers with nonspecific low back pain. JAP 2023; 13(4): 95-110. .[Persian]
  11. Mazloum V, Sahebozamani M. The comparison of stabilization exercise program and Pilates method on patients with non-specific chronic low back pain. 2014; 22(1): 59-68. [Persian]
  12. Sokhanguei Y, Sadoughi Noorabadi M, Sadoughi Noorabadi N, Hatami M. The effect of a Pilates program on chronic non-specific lower back pain and stable range of motion in 40 to 60 year old women.   J Adv Med Biomed Res 2017; 25(108): 20-30. .[Persian]
  13. Ali Zamani S, Ghasemi GA, Karimi A, Salehi H. Pilates exercise effect on pain and general health of female patients with chronic low back pain. JRRS  2011;7 (1): 1-9. .[Persian]
  14.  
  15. Tsao H, Hodges PW. Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. J electromyogr Kinesiol 2008; 18(4): 559-567.
  16. Kim S, Yi D, Yim J. The effect of core exercise using online videoconferencing platform and offline-based intervention in postpartum woman with diastasis recti abdominis. Int J Environ Res Public Health 2022; 19(12): 7031.
  17. Ehsani F, Sahebi N, Shanbehzadeh S, Arab AM, ShahAli S. Stabilization exercise affects function of transverse abdominis and pelvic floor muscles in women with postpartum lumbo-pelvic pain: a double-blinded randomized clinical trial study. Int Urogynecol J 2020; 31(1): 197-204. .[Persian]
  18. El-Mekawy HS, Eldeeb AM, El-Lythy MA, El-Begawy AF. Effect of abdominal exercises versus abdominal supporting belt on post-partum abdominal efficiency and rectus separation. International Journal of Medical and Health Sciences 2013; 7(1): 75-79.
  19. Mota P, Pascoal AG, Sancho F, Bø K. Test-retest and intrarater reliability of 2-dimensional ultrasound measurements of distance between rectus abdominis in women. J Orthop Sports Phys Ther 2012; 42(11): 940-946.
  20. Teyhen DS, Gill NW, Whittaker JL, Henry SM, et al. Rehabilitative ultrasound imaging of the abdominal muscles. J Orthop Sports Phys Ther 2007; 37(8): 450-466.
  21. Hosseinifar M, Akbari A, Shahrakinasab A. The effects of McKenzie and lumbar stabilization exercises on the improvement of function and pain in patients with chronic low back pain: a randomized controlled trial. Journal of Shahrekord University of Medical Sciences 2009; 11(1):1-9. [Persian]
  22. Zahedpour F, Mohammadi M, Damavandi M, Agah J. The effect of core stability training on postpartum lumbar lordosis and low back pain in nulliparous women. The Iranian Journal of Obstetrics, Gynecology and Infertility 2017; 20(3): 89-97. [Persian]
  23. Kamel DM, Yousif AM. Neuromuscular electrical stimulation and strength recovery of postnatal diastasis recti abdominis muscles. Ann Rehabil Med 2017; 41(3): 465-474.
  24. 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.
  25. Yalfani A, Bigdeli N, Gandomi F. The Effect of Isometric-Isotonic Exercises of Core Stability in Women with Postpartum Diastasis Recti and Its Secondary Disorders (Randomized Controlled Clinical Trial). JHC 2020; 22(2): 123-137. .[Persian]
  26. Pereira C. DAS, & (PT), DSG To study the added effect of modified dynamic core stability plank exercise program on diastasis recti abdominis closure and pelvic floor disability: a pilot study. IJAMSCR 2018; 6(2): 8.
  27. Fan C, Guidolin D, Ragazzo S, Fede C, et al. Effects of cesarean section and vaginal delivery on abdominal muscles and fasciae. Medicina(Kaunas) 2020; 56(6): 260.
  28. Fukano M, Tsukahara Y, Takei S, Nose-Ogura S, et al. Recovery of abdominal muscle thickness and contractile function in women after childbirth. International Int J Environ Res Public Health 2021; 18(4): 2130.
  29. Theodorsen N, Strand L, Bø K. Effect of pelvic floor and transversus abdominis muscle contraction on inter-rectus distance in postpartum women: a cross-sectional experimental study. Physiotherapy 2019; 105(3): 315-320.
  30. Rezaei A, Mahdavinejad R, Shamloo Rezaei S. Pilate’s Selected Exercises Effects On Muscles Strength, Trunk Joints Range Of Motion And Flexibility Of Women With Hyperlordosis In Immediate Post-Partum. Nursing and Midwifery Journal 2015; 13(3): 198-207. .[Persian]
  31. Jobanputtra Y, Patil S. Immediate Effect of Kinesio-Taping on Lumbopelvic Stability in Postpartum Women With Diastasis Recti: A Review. Cureus 2023; 15(1): e33347.
  32. Bikaran M, Shirzad E, Barati AH. The Effect of 16 Weeks of Pilates Training on Trunk Core Stability in Menopausal Women. Sport Sciences and Health Research 2016; 8(1): 1-14. .[Persian]
Journal of Paramedical Sciences & Rehabilitation
Volume 12, Issue 2
September 2023
Pages 7-18

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