The effects and experiences of training the rectus abdominis muscle in women with diastasis rectus abdominis postpartum.

Abstract: Background: Diastasis rectus abdominis (DRA) is a separation of the rectus abdominis during and after pregnancy. Physiotherapy is the first choice of intervention but it is unclear which type of training is the most effective.  Purpose: The aim of the study was twofold. The aim of the first part was to evaluate the effects of training the rectus abdominis in women with DRA postpartum. The aim of the second part was to describe how these women experienced this training program.  Method: Three women were included in the study. Firstly a single subject experimental design with A-B design was implemented. Inter-recti distance (IRD), activity impairment, muscle strength and endurance, pain and aesthetics was measured. Secondly a qualitative design was carried out to describe the participants' experiences. It was implemented with interviews analyzed with qualitative content analysis.  Results: Two of the participants got significantly decreased IRD. One of the participants got significantly improved in the activity impairment ´getting up from lying down with and without a weight´. There was no improvement in the other outcome measures. Two categories comprised by two subcategories each were identified by the qualitative analysis: positive and motivating experiences of the training and experiences of positive results of the training. The categories reveal positive experiences of the training design and exercises as well as becoming stronger and gaining trust to use the body again as the main result after the training period. Conclusion: An individually designed training program focusing on the rectus abdominis muscle could be effective for reducing the IRD and getting stronger when getting up from lying down in women with DRA 2-12 months postpartum. Training the rectus abdominis with regular supervision was experienced positively and motivating after pregnancy. The most important experienced result was becoming stronger and gaining increased trust in the body.