A comparison of overall function between postpartum women with and without diastasis rectus abdominis

Abstract

Presented to the 21st Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Rhatigan Student Center, Wichita State University, April 11, 2025.Research completed in the Department of Physical Therapy, College of Health Professions.INTRODUCTION: Diastasis rectus abdominis (DRA) is a separation of the left and right rectus abdominis at the linea alba (LA) and is prevalent in up to 83% of postpartum women. Previous research shows a relationship between DRA, urinary incontinence, and low back/ abdominal pain; however, DRA’s impact on a woman’s overall function in the postpartum period is not well understood. The effects DRA has on functional status needs to be investigated so that physical therapists and other providers can understand the rehabilitative needs of postpartum women. The null hypothesis of this study was that there would be no significant difference in overall functional ability between postpartum women who have DRA versus those who do not. PURPOSE: The purpose of this study was to examine the functional status of women after childbirth and determine differences in function in women with or without DRA. METHODS: In this methodological study, postpartum women ages 18-40 between 6-10 weeks postpartum were recruited through flyers and social media, surveyed with the Inventory of Functional Status After Childbirth (IFSAC), participated in a telehealth visit, and completed an in-person visit to measure the abdominal muscles with real-time ultrasound to determine DRA diagnosis status. IFSAC scores were compared between postpartum women with and those without a DRA. RESULTS: Twenty-six women who were on average 28 years old, 7.3 weeks postpartum, and experienced an average of 1.6 vaginal deliveries, completed all phases of this study. Results of an independent t-test revealed overall function IFSAC scores between women with DRA (M = 3.35, SE = 0.08) and women without DRA (M = 3.42, SE = 0.15). This difference, 0.07, CI 95% [-0.27, 0.41] was not significant t (26) = 0.406, p = 0.336, with a small-medium effect size of d = 0.37. CONCLUSION: The results of this study sheds light on potential functional effects of a DRA on postpartum women and bring awareness of the impact of pregnancy. This knowledge will guide practitioners in appropriate intervention selection for this population. Although this study did not find a statistically significant difference in overall functional scores between postpartum women with and postpartum women without DRA, it does show a potential downward trend of functional status in women with DRA. Further research should consider comparing women with more severe inter-rectus distances (greater than 4.0 cm). More severe separation has been shown to decrease lumbopelvic stability, and therefore, will likely impact overall function. More research is needed to understand the lingering musculoskeletal effects of pregnancy in the fourth trimester. These women must not only take care of a newborn baby but also need to rehabilitate their own bodies to return to a functional life beyond childbearing.Graduate School, Academic Affairs, University Librarie