A Multidimensional Investigation of Diastasis Recti Abdominis Treatment and Assessment in Postpartum Women: A Systematic Review and Meta-Analysis

Elham  Soleimanzadeh; Hakimeh  Adigozali; Hanieh  Salehi-Pourmehr; Morteza  Ghojazadeh; Fariba  Ghaderi; Jalal  Ahadi

doi:10.18502/jmr.v18i4.16909

Elham Soleimanzadeh Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Hakimeh Adigozali Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Hanieh Salehi-Pourmehr Research Center for Evidence-Based Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Morteza Ghojazadeh Research Center for Evidence-Based Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Fariba Ghaderi Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Jalal Ahadi Department of Physiotherapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

DOI: https://doi.org/10.18502/jmr.v18i4.16909

Keywords: Diastasis recti; Physiotherapy; Exercise therapy; Ultrasonography; Systematic review

Abstract

Introduction: Diastasis recti abdominis (DRA) is prevalent among postpartum women, with various physiotherapy treatments utilized. Despite the effectiveness of diverse DRA treatment methods and the importance of evaluating its levels and methods, limited attention has been given to this aspect. This study comprehensively investigates DRA, examining evaluation levels and methods, and assessing the efficacy of diverse physiotherapy interventions.

Materials and Methods: Online search was conducted in Cochrane, ProQuest, PubMed, Embase, Scopus, Web of Science, Google Scholar, and Magiran databases until the end of 2022, employing the population, intervention, comparison, and outcome framework (population = DRA, intervention = physiotherapy, comparison = control, and outcome = inter- rectus-distance [IRD]). The JBI checklist and Cochrane Collaboration RoB 2.0 tool evaluated critical appraisal and bias risk. Meta-analysis was performed using the RevMan software.

Results: The study included 16 articles with 650 postpartum women. The findings revealed no significant differences in various measurement methods (P=0.25) and levels (P=0.10). Combination therapy demonstrated greater effectiveness than exercise alone in reducing IRD (P=0.04), with tape being particularly impactful (P=0.009).

Conclusion: Although sonography evaluation of IRD above the umbilicus is recommended, the study highlights the limitation of diverse measurement methods and levels in determining the optimal physiotherapy intervention. Despite the preference for combined interventions, especially tape alongside exercise for women with DRA, further research is essential due to limited evidence, aiming to provide greater insights into this issue.