561 the Effect of a Postpartum Diastasis Rectus Strengthening Program

Diastasis rectus abdominis (DRA) is a separation of the abdominal wall that often occurs in pregnancy, including up to 60% of postpartum women. Several studies have shown core strengthening improved DRA, but there is no widely accepted exercise program directed at this condition. Our objective was to determine the effect of a core strengthening program on inter-rectus distance (IRD) in postpartum women diagnosed with diastasis rectus abdominis (DRA). We conducted a prospective non-randomized trial in which forty healthy, non-pregnant women who were 3-36 weeks postpartum were consecutively assigned to Group A (19) or Group B (21). DRA was diagnosed as an IRD ≥ 2.0cm on ultrasound. Group A participated in the online core training program for 12 weeks followed by a maintenance phase for 12 weeks, while Group B participated in the initial 12 weeks training program only. A single investigator performed all ultrasound measurements, and participants were asked to forgo all exercises outside of the program for its duration until final measurements were collected. The 12 week core strengthening program significantly decreased IRD above and below the umbilicus at rest (-0.57cm; p<0.001, -0.31; p=0.004, respectively), and below the umbilicus during contraction (-0.4cm; p<0.001). Significant improvements in stress urinary incontinence (SUI) p=0.002 and lower back pain (LBP) p=0.027 were also observed in both groups. Group A had significantly lower IRD at 24 weeks (2.79cm) compared to 12 weeks (1.95cm). The online 12-week core strengthening program reduced IRD, and improved SUI and LBP. Participation for an additional 12 weeks resulted in further IRD reduction. These results suggest that a core strengthening program is effective and safe at reducing IRD, and that continuation for 24 weeks further improves DRA.