I'm not just a PT, I'm also a parent!

I'm not just a PT, I'm also a parent!

Tuesday, October 2, 2012

Diastasis Recti (part 4) - Research

Research Articles regarding Diastasis Recti

Here is a list of research articles about Diastasis Recti so that you can learn more about the condition and the various treatment options.  I am not endorsing any one treatment option and am just including the studies so that my readers can make informed decisions regarding their medical treatment.  Remember, everyone is different and everyone's Diastasis Recti can present differently.  Always consult your doctor first! 

from www.bodyalignpt.com

Diastasis Recti and Pregnancy

Ranney B (1990 Oct). Diastasis recti and umbilical hernia causes, recognition, and repair. S D J Med, 43(10): 5-8.
This article discusses how to recognize diastasis recti in post-partum women.  These women expressed a desire for post-operative improvements in firmness and function of the lower abdominal wall.  The article also discusses methods of recognition and repair of diastasis recti of varying severities.

Boissonnault JS, Blaschak MJ (1988 Jul). Incidence of diastasis recti abdominis during the childbearing year. Phys Ther, 68(7): 1082-6.
This study determined that diastasis recti occurred most often at the umbilicus (belly button).  There was a significant relationship between the timing during a woman's pregnancy and the presence or absence of a diastasis recti.  It was initially noted during the second trimester, but incidence peaked in the third trimester.  The researchers concluded that it is important to assess for diastasis recti above, below, and at the umbilicus throughout pregnancy.

Bursch SG (1987 Jul). Interrater reliability of diastasis recti abdominis measurement. Phys Ther, 67(7): 1077-9.
This study's goal was to provide data regarding the incidence and degree of diastasis recti, to describe the measurement system used, and to determine the interrater reliability of the measurements.  Forty women who were immediately post-partum were tested via palpation by four raters.  This measurement system was found to be unreliable among raters.  All 40 subjects had some degree of diastasis recti and the authors conclude that the incidence and severity of diastasis recti may be underdiagnosed and that a reliable method of measuring the amount of separation is needed.

Mota P, Pascoal AG, Sancho F, Bo K (1988 Jul). Test-retest and intrarater reliability of 2D ultrasound measurements of distance between rectus abdominis in women. J Orthop Sports Phys Ther, [Epub ahead of print]
This research study found that ultrasound imaging is a reliable method for measuring the inter-rectus distance at rest and during abdominal crunch and drawing-in exercises

Diastasis Recti Treatment

 Chiarello CM, Falzone LA, McCaslin KE, Patel MN, Ulery KR (2005 Spring). The Effects of an Exercise Program on Diastasis Recti Abdominis in Pregnant Women. Journal of Women's Health Physical Therapy, 29(1): 11-16.
This research study used the Tupler Technique and found that the occurrence and size of Diastasis Recti is much greater in non‐exercising pregnant women than in exercising pregnant women. 

Tadiparthi S, Shokrollahi K, Doyle GS, Fahmy FS (2011 Oct 20). Rectus sheath plication in abdominoplasty: assessment of its longevity and a review of the literature. J Plast Reconstr Aesthet Surg, 65(3): 328-32.  

The article concludes that plication (folding over and tucking loose tissue, then suturing it together) with non-absorbable sutures is long-lasting and durable.

Hickey F, Finch, JG, Khanna A (2009 Jun). A systematic review on the outcomes of correction of diastasis of the recti. Hernia, 13(3): 287-92.
Though it is primarily cosmetic, except in the case of herniation, there is high patient satisfaction after surgical correction of diastasis recti.
Palanivelu C, Rangarajan M, Jateaonkar PA, Amar V, Gokul KS, Srikanth B (2004 Jul-Aug). Laparoscopic repair of diastasis recti using the 'Venetian blinds' technique of plication with prosthetic reinforcement: a retrospective study. Aesthetic Plast Surg, 28(4): 189-96. 
 This was written by plastic surgeons, so they advocate surgical repair of diastasis recti for cosmetic reasons and to restore abdominal muscle function.  The authors state that use of a prosthesis is necessary to prevent recurrence.

Nahas FX, Ferreira LM, Mendes Jde A (2004 Jul-Aug). An efficient way to correct recurrent rectus diastasis. Aesthetic Plast Surg. 28(4). 189-96.

I need to get my hands on the full text of this study for all the details, but basically they conclude that the procedure of advancement of the recti muscles seems to be a reliable method for correcting recurrent rectus diastasis in patients with surgically repaired rectus abdominus muscles that were inserted laterally, near the ribs.

Nahas FX, Augusto SM, Ghelford C (1994 Jan). Should diastasis recti be corrected?.Aesthetic Plast Surg. 21(4): 285-9.
The researchers performed CT scans on patients who had surgical repair of their diastasis recti.  After 6 months, they had complete correction.
Asaadi M, Haramis HT (1994 Jan). A simple technique for repair of rectus sheath defects. Ann Plast Surg. 32(1): 107-9.
This study describes one particular surgical method that has shown no recurrence or herniation.

General articles regarding Diastasis Recti

Brauman D (2008 Nov). Diastasis recti: clinical anatomy.  Plast Reconstr Surg.  122(5): 1564-9.
92 abdominoplasty patients were studied and the researcher found that: the linea alba only stretches 1-2 inches, abdominal wall protrusions can be caused by distension of the entire abdominal wall, significant protrusions can occur without diastasis, and those with flat abdomens may still have a diastasis.

Repta R, Hunstad JP (2009 Jun). Diastasis recti: clinical anatomy. Plast Reconstr Surg. 123(6): 1885; author reply 1885-6. 
This is a comment regarding the article mentioned above.  I hope to find the full text soon because I'd love to know what everyone has to say about this!

Braekken IH, Majida M, Ellstrom Engh M, Holme IM, Bo K (2009 Dec). Pelvic floor function is independently associated with pelvic organ prolapse. BJOG. 116(13): 1706-14.
Diastasis recti may be a factor in pelvic organ prolapse.

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