Technical aspects of inter-recti distance measurement with ultrasonographic imaging for physiotherapy purposes: the scoping review

Background: Inter-recti distance (IRD) measurement using musculoskeletal USI has been used in physiotherapy research, in particular, to investigate pregnancy-related diastasis recti abdominis (DRA) and to seek its effective treatment methods. Severe and untreated diastasis may result in the formation of umbilical or epigastric hernias. Objective: This study aimed to systematically map physiotherapy-related research articles that included descriptions of IRD measurement procedures using USI to present their similarities and differences, and formulate recommendations on the procedure. Design: A scoping review was conducted according to PRISMA-ScR guidelines, including 49 of 511 publications from three major databases. Publications were selected and screened by two independent reviewers whose decisions were consulted with a third reviewer. The main synthesized data items were: the examinees' body position, breathing phase, measurement sites, and DRA screening methods. The final conclusions and recommendations were the result of a consensus between seven reviewers from four research centers. Results: Studies used 1-5 measurement sites that were differently determined. IRD was measured at the umbilicus (n = 3), at its superior (n = 16) and/or inferior border (n = 9), and at different levels: between 2 and 12 cm above the umbilicus, or a third of the distance and halfway between the umbilicus and xiphoid (n = 37); between 2 and 4.5 cm below the umbilicus or halfway between the umbilicus and pubis (n = 27). Different approaches were used to screen subjects for DRA. Conclusions: The discrepancies between the measurement procedures prevent between-study comparisons. The DRA screening method should be standardized. IRD measurement protocol standardization has been proposed. Critical relevance statement: This scoping review indicates that the inter-recti distance measurement procedures using ultrasound imaging differ between studies, preventing between-study comparisons. Based on the synthesis of the results, measurement protocol standardization has been proposed. Key points: The inter-recti distance measurement procedures using USI differ between studies. Proposed standardization concerns body position, breathing phase, and measurement number per location. Determination of measurement locations considering individual linea alba length is suggested. Recommended locations: umbilical top, ½ of umbilical top-xiphoid, ¼ of umbilical top-xiphoid/pubis distances. Diastasis recti abdominis diagnostic criteria are needed for proposed measurement locations.The Jerzy Kukuczka Academy of Physical Education has funded the article’s editorial expenses.info:eu-repo/semantics/publishedVersio

A prospective longitudinal comparison of the sacral inclination angle in women between their early and advanced pregnancy and 6-month postpartum follow-up

The impact of pregnancy on the anterior-posterior sacral orientation and its relation to lumbopelvic pain and weight gain has not been fully recognized. This longitudinal study aimed to compare the sacral inclination angle in women between their early and advanced pregnancy and at 6 months postpartum. The authors also searched for a correlation between the sacral inclination and lumbopelvic pain, BMI and change in body mass. Methods: Thirteen healthy women participated in the study. Data were collected at 8–16 and 35–38 weeks of gestation, and at 27–31.5 postpartum weeks. At each session, the women’s sacral inclination angles were measured using the Saunders digital inclinometer. Data were also collected on lumbopelvic pain, BMI and body mass gain/loss. Results: There was no effect of the evaluation period on the sacral inclination ( p > 0.05); however, various individual values of the sacral inclination in pregnancy and postpartum were noted. In advanced pregnancy, 61.5% of the women had recurrent pain in the lumbopelvic region. The sacral inclination did not correlate with the lumbopelvic pain, BMI and body mass change ( p > 0.05) in the pregnancy and postpartum periods. Conclusions: Advanced pregnancy did not influence sacral inclination. However, individuals varied in their responses. Therefore, we suggest that an individually-based physical therapy approach concerning proper posture during and after pregnancy should be emphasized. The sacral inclination had no impact on the occurrence of recurrent lumbopelvic pain. BMI and changes in body mass did not influence the sacral inclination in advanced pregnancy and at 6 months postpartum

Rozejście mięśni prostych brzucha u kobiet we wczesnym połogu

Aim of study: Diastasis recti abdominis is a widening of the linea alba leading to separation of the recti muscles. This abnormality concerns mainly women during their perinatal period. The objective of this study is to determine the incidence of diastasis recti abdominis in women during their early postpartum period. We also attempted to verify the relationship between the women’s linea alba width and the number of their deliveries. Methods: In this study, data from medical interviews as well as the results of a diastasis recti test among 52 women between their 3rd and 5th day after delivery were analysed. Pearson’s Chi2 and Spearman’s correlation tests were used to search for relationships between variables. Results: Among the 52 women, 33 (63%) demonstrated increased separation of recti muscles (a positive diastasis recti test at the level of the umbilicus). Statistical analysis indicated a moderate positive correlation between the width of linea alba and the number of deliveries (r = 0.4; p < 0.05). Diastasis recti abdominis occurred in 14 of the 28 primigravidas (50%) and in 19 of the 24 multigravidas (79%; p < 0.05). Conclusions: The results of this study indicate that over half of the women in the early postpartum period had diastasis of the recti abdominis muscles. In multiparous women, there may be a higher risk of diastasis recti abdominis occurrence.Cel pracy: Rozejście mięśni prostych brzucha to poszerzenie kresy białej i rozsunięcie brzuśców mięśni prostych na boki. Problem ten najczęściej dotyczy kobiet w ciąży i po porodzie. Celem pracy było sprawdzenie częstości występowania rozstępu mięśni prostych brzucha u kobiet we wczesnym połogu oraz odpowiedź na pytanie, czy istnieje zależność pomiędzy szerokością kresy białej a liczbą przebytych porodów. Metody: W pracy wykorzystano dane z wywiadu oraz wyniki testu na rozpoznanie rozejścia mięśni prostych brzucha wykonanego u 52 kobiet będących między trzecią a piątą dobą po porodzie. Do zbadania zależności między zmiennymi wykorzystano test niezależności chi2 Pearsona. Do określenia siły związku pomiędzy cechami zastosowano współczynnik korelacji rangowej Spearmana. Wyniki: U 33 z 52 kobiet (63%) stwierdzono rozejście mięśni prostych brzucha na wysokości pępka. Analiza statystyczna wykazała umiarkowaną dodatnią zależność pomiędzy szerokością kresy białej a liczbą przebytych porodów (r = 0,4; p < 0,05). Rozejście mięśni prostych brzucha dotyczyło 14 z 28 pierworódek (50%) oraz 19 z 24 wieloródek (79%; p < 0,05). Wnioski: Wyniki niniejszej pracy wskazują, że problem rozejścia mięśni prostych brzucha dotyczył ponad połowy kobiet we wczesnym połogu. U wieloródek może istnieć większe ryzyko wystąpienia rozejścia mięśni prostych niż u pierworódek

Static Postural Stability in Women during and after Pregnancy: A Prospective Longitudinal Study

<div><p>This longitudinal study aimed to compare static postural stability in women between early pregnancy, advanced pregnancy, and at 2 and 6 months postpartum. Forty-five pregnant women were enrolled and 31 completed the protocol. Data were collected at 7–16 and 34–39 weeks gestation, and at 6–10 and 26–30 weeks postpartum. For each subject, the center of foot pressure path length and mean velocity (with directional subcomponents) were computed from 30-s long quiet-standing trials on a stationary force plate with eyes open or closed. The body mass, stance width, and sleep duration within 24 h before testing were also recorded. Static postural stability was not different between pregnancy and postpartum, except for the anterior posterior sway tested in the eyes-closed condition, which was significantly increased in late pregnancy compared to that at 2 and 6 months postpartum. Pregnant/postpartum women’s body mass weakly positively correlated with anterior-posterior sway in the eyes-closed condition and their stance width weakly positively correlated with the anterior-posterior sway in the eyes-open condition. No effect of sleep duration on postural sway was found. Our findings indicate that under visual deprivation conditions women in advanced pregnancy may have decreased static stability compared to their non-pregnant state.</p></div

Characteristics of 31 women in early (P1) and advanced (P2) pregnancy and at 2 (P3) and 6 (P4) months postpartum.^*

<p>* Data are shown as means ± SD. BMI–body mass index</p><p>Characteristics of 31 women in early (P1) and advanced (P2) pregnancy and at 2 (P3) and 6 (P4) months postpartum.^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0124207#t001fn001" target="_blank">*</a>}</p

Center of pressure measures reflecting spontaneous body sway during 30 s of quiet standing with the eyes open (EO) or closed (EC) in 31 women in early (P1) and advanced (P2) pregnancy and at 2 (P3) and 6 (P4) months postpartum.^*

<p>AP–anterior-posterior plane, ML–medial-lateral plane.</p><p>* Data are shown as means ± SD.</p><p>** Significantly decreased from P2 to P3 (p = 0.014) and from P2 to P4 (p = 0.017), Fisher’s LSD post-hoc; RM ANOVA: F_{3, 90} = 2.71, p = 0.049.</p><p>Center of pressure measures reflecting spontaneous body sway during 30 s of quiet standing with the eyes open (EO) or closed (EC) in 31 women in early (P1) and advanced (P2) pregnancy and at 2 (P3) and 6 (P4) months postpartum.^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0124207#t002fn002" target="_blank">*</a>}</p