Mota P.1,2, Pascoal A.G.1, Carita A.I.1, Bø K.3
1University of Lisbon, Faculty of Human Kinetics, Lisboa, Portugal, 2Atlântica University Higher Institution, Lisboa, Portugal, 3Norwegian School of Sport Sciences, Department of Sports Medicine, Oslo, Norway
Background: Diastasis recti abdominis is characterized by a midline separation of the two rectus abdominis muscles along the linea alba. The inter-rectus distance (IRD) widens in pregnant women, and at 6 months postpartum many have not recovered. The width of the linea alba is equivalent to the IRD.
There are normative values on the width of the linea alba for nulliparous women (up to a width of 15 mm at the xiphoid, up to 22 mm at 3 cm above the umbilicus and up to 16 mm at 2 cm below the umbilicus), but to date there are few studies about the normal width of the IRD in postpartum women. Normative reference values for the IRD in primiparous women are essential to identify deviation from normal and evaluate response to treatment.
There are normative values on the width of the linea alba for nulliparous women (up to a width of 15 mm at the xiphoid, up to 22 mm at 3 cm above the umbilicus and up to 16 mm at 2 cm below the umbilicus), but to date there are few studies about the normal width of the IRD in postpartum women. Normative reference values for the IRD in primiparous women are essential to identify deviation from normal and evaluate response to treatment.
Purpose: To evaluate the width of the linea alba, or the IRD, measured at three reference points in a group primiparous women 6 months postpartum.
Methods: This was a cross-sectional observational study.
Ultrasound images were recorded in 84 primiparous women with a 12 MHz scanner (GE Logic-e) at rest on three different locations on the linea alba (2 cm below the umbilicus and 2 and 5 cm above the umbilicus). The 20th and 80th percentiles were calculated to define the normal width of the IRD.
Results: The examination revealed a broad range of values at the three reference points measured.
The width of the IRD at 2 cm above the umbilicus was significantly greater than at 2 cm below and 5 cm above the umbilicus (P 0.001).
There was no significant correlation of age or body height with IRD.
The 20th and 80th percentiles indicate that at 6 month postpartum, the linea alba width can be considered normal from 9 to 21 mm at 2 cm below the umbilicus; from 17 to 28 mm at 2 cm above the umbilicus; and from 12 to 24 mm at 5 cm above the umbilicus.
Conclusion(s): The IRD varies along the linea alba. In primiparous women at 6 months postpartum the IRD is wider than the literature reference values for nulliparous women. Further studies with large sample size are warranted.
Implications: The normative values for the width of the IRD should be defined at different reference locations on the linea alba. In primiparous women the IRD may be considered normal up to values wider than for nulliparous women.
In clinical practice there is a need for physiotherapists to identify the different normative values for the IRD, depending on different conditions (e.g. parity), so that deviations from normal are accurately accessed.
Funding acknowledgements: This study was supported by the Portuguese Foundation for Science and Technology
and by the International Society of Biomechanics Grant.
and by the International Society of Biomechanics Grant.
Topic: Women's & mens pelvic health
Ethics approval: The study was approved by the Review Board of the University of Lisbon, Faculty of Human Kinetics, Portugal.
All authors, affiliations and abstracts have been published as submitted.
