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Djivoh Y1, De Jaeger D1
1UCL, Faculté des Sciences de la Motricité, Louvain-la-Neuve, Belgium
Background: Diastasis recti (DR) appears frequently during pregnancy. Its prevalence is estimated at 60% at 6 weeks postpartum. In relation to DR, a higher incidence of low back pain and pelvic floor disorders was reported. According to recent studies, Crunch (lifting the trunk until the top of scapula is just off) has a positive (decrease) effect on DR. However, physiotherapists do not practice it because of its probably hyperpressive nature. They prefer the Hypopressive abdominal gymnastics (HAG, drawing the belly in, followed by diaphragmatic aspiration). The effect of HAG on DR has not been studied. According to the hypopressive nature of HAG, combining HAG with Crunch should be safe for women pelvic floor and we wonder if this combination would decrease the DR.
Purpose: This study aimed to test if different variants of Crunch, and specifically the combination of Crunch with HAG decrease the DR.
Methods: The DR was measured during five exercises: Head-up (lifting the head only), Crunch, Exaggerated-Crunch (lifting the trunk beyond the top of scapula), Drawing-in-Crunch (drawing the belly in and adding Crunch), and HAG-Crunch (doing HAG and adding Crunch). Sample size calculation was based on the DR variation between different movements measured by Lee and Hodges. A mean (SD) difference of 0.6 cm (0.4) during Crunch compared to rest was reported. With α = 0.05 and 1 - β = 0.9, fifteen participants were required. Nineteen women who have given birth since 3 months to 20 years, aged between 28 and 54 were selected for this study. We used dial caliper to measure DR 2 cm above umbilicus during each movement repeated twice. The average of the two measures was used for analysis. The DR was compared through five movements using a One-way ANOVA with repeated measures. Post-hoc with Bonferroni test was used to locate the difference between the movements. The significant level was set at p 0.05.
Results: Compared to the Head-up, the DR significantly decreased by 0.8 cm during the Crunch and Exaggerated-Crunch (p 0.001). No significant difference in DR was noted between Head-up, HAG-Crunch and Drawing-in-Crunch.
Conclusion(s): In contrary to our hypothesis, the combination of Crunch with HAG did not decrease the DR. The Crunch decreased the DR according to previously published results. Furthermore, we showed that Exaggerated-Crunch did not decrease more the DR than Crunch. The observed decrease being immediate, it is important to measure the long-term effect of a training program focused on Crunch.
Implications: Despite the positive effect of Crunch on DR, it's not sufficient to advise it in postpartum. Its effect on pelvic floor must be considered.
Keywords: Abdominal exercises, Postpartum, Dial caliper
Funding acknowledgements: We thank the women who participated in this study. Funding source: None.
Purpose: This study aimed to test if different variants of Crunch, and specifically the combination of Crunch with HAG decrease the DR.
Methods: The DR was measured during five exercises: Head-up (lifting the head only), Crunch, Exaggerated-Crunch (lifting the trunk beyond the top of scapula), Drawing-in-Crunch (drawing the belly in and adding Crunch), and HAG-Crunch (doing HAG and adding Crunch). Sample size calculation was based on the DR variation between different movements measured by Lee and Hodges. A mean (SD) difference of 0.6 cm (0.4) during Crunch compared to rest was reported. With α = 0.05 and 1 - β = 0.9, fifteen participants were required. Nineteen women who have given birth since 3 months to 20 years, aged between 28 and 54 were selected for this study. We used dial caliper to measure DR 2 cm above umbilicus during each movement repeated twice. The average of the two measures was used for analysis. The DR was compared through five movements using a One-way ANOVA with repeated measures. Post-hoc with Bonferroni test was used to locate the difference between the movements. The significant level was set at p 0.05.
Results: Compared to the Head-up, the DR significantly decreased by 0.8 cm during the Crunch and Exaggerated-Crunch (p 0.001). No significant difference in DR was noted between Head-up, HAG-Crunch and Drawing-in-Crunch.
Conclusion(s): In contrary to our hypothesis, the combination of Crunch with HAG did not decrease the DR. The Crunch decreased the DR according to previously published results. Furthermore, we showed that Exaggerated-Crunch did not decrease more the DR than Crunch. The observed decrease being immediate, it is important to measure the long-term effect of a training program focused on Crunch.
Implications: Despite the positive effect of Crunch on DR, it's not sufficient to advise it in postpartum. Its effect on pelvic floor must be considered.
Keywords: Abdominal exercises, Postpartum, Dial caliper
Funding acknowledgements: We thank the women who participated in this study. Funding source: None.
Topic: Musculoskeletal: spine; Women's & men's pelvic health; Musculoskeletal: spine
Ethics approval required: Yes
Institution: Université Catholique de Louvain (UCL) - Belgium
Ethics committee: Comité d'étique Hospitalo-facultaire
Ethics number: 0032 027645514
All authors, affiliations and abstracts have been published as submitted.
