Physiotherapy in a patient with diastasis of the rectus abdominis muscle after childbirth

Abstract

Background: Examination for the presence of diastasis of the rectus abdominis muscle and examination of the entire posture is very important in postpartum women. Currently, examination by 2D ultrasound, caliper and palpation is used. It is examined at rest and during stress tests. Methods: Case study of a patient with diastasis of the direct abdominal muscle after a fi rst spontaneous uncomplicated delivery at the age of 32 years. Examination to confirm diastasis of the rectus abdominis muscle – the width of linea alba was measured with a 2D linear probe by ultrasound 4.5 cm above the umbilicus, in the region of the umbilicus and 4.5 cm below the umbilicus. Lying on the back at rest, and with elevation of the lower limbs. The degree of severity was classified into four grades. A standard physiotherapy postural examination was performed. A part of the intervention was individual exercise with activation of the m. transversus abdominis to reduce diastasis of the direct abdominal muscles. The exercise program included postural adjustment, modification of breathing stereotype and quality, and activation of pelvic floor muscles. Exercises to reduce pain in the ligamentous apparatus and training in correct ergonomics were also performed. The dosage of exercise was 15 min per day in the 1st week of treatment, 2–4 week of treatment 20 min per day, 5–12 week of treatment 30 min per day, 5 days per week, for 12 weeks. Conclusion: The effect of exercise with activation of m. transversus abdominis on the reduction of diastasis of the direct abdominal muscle in the postpartum patient was objectively proven by the above mentioned objectification methods. Key words: exercise – diastasis of the rectus abdominis muscle – objectification