Overview
This clinical trial is designed to investigate the efficacy of various interventions in
treating Diastasis Recti Abdominis (DRA) among postpartum women. DRA is a condition
characterized by the separation of the left and right sides of the rectus abdominis
muscle, commonly occurring during and after pregnancy. This separation can lead to
functional impairments such as lower back pain, pelvic floor dysfunctions, and a decrease
in core stability, which significantly affects a woman's quality of life.
Purpose
The study aims to assess and compare the effectiveness of four different treatment
modalities: Visceral Manipulation (VM), Kinesio Taping (KT), a combination of both VM and
KT, and core strengthening exercises. The primary goal is to determine which treatment(s)
most effectively reduce the inter-recti distance (IRD), thus alleviating the physical and
functional symptoms associated with DRA. Secondary objectives include evaluating the
impact of these treatments on associated pain levels, pelvic floor muscle strength, and
urinary incontinence, which are common concerns among affected postpartum women.
Study Design
This randomized controlled trial will enroll participants from four major maternity
hospitals across Karachi, Pakistan, ensuring a diverse participant pool. Upon meeting
inclusion criteria, participants will be randomly assigned to one of the four
intervention groups. Each group will receive a specific treatment protocol for six weeks,
with assessments scheduled at baseline, the three-week midpoint, and upon completion at
six weeks.
Group A: Participants will receive Kinesio Taping applied with approximately 70% tension
in a crisscross pattern over the rectus abdominis muscle.
Group B: Participants will undergo Visceral Manipulation, focusing on enhancing the
mobility and function of abdominal and pelvic organs.
Group C: This group will receive both VM and KT as combined therapies to maximize the
therapeutic benefits.
Group D: Participants in this group will perform targeted core strengthening exercises
designed to enhance muscle function and support abdominal healing.
Methodology
Treatment efficacy will be evaluated through a series of quantitative and qualitative
measurements:
Inter-Recti Distance (IRD): Measured using the finger-width palpation method, this metric
will directly assess the physical gap between the rectus abdominis muscles.
Pain Level: Assessed using the Visual Analogue Scale (VAS), allowing participants to
report the intensity of their pain.
Pelvic Floor Muscle Strength: Evaluated using pressure biofeedback units, providing
objective data on muscle functionality.
Urinary Incontinence: Measured via the Urinary Distress Inventory-6 (UDI-6), which
quantifies symptoms of urinary incontinence.
Data Analysis
Data will be processed and analyzed using the Statistical Package for the Social Sciences
(SPSS), version 21.0. Analysis of Covariance (ANCOVA) will be used to compare treatment
effects across the groups, adjusting for potential confounders like age and BMI. Repeated
measures ANOVA will be employed to evaluate changes within each group over time.
Ethical Considerations
The study has been reviewed and approved by an Institutional Review Board, ensuring that
all procedures adhere to ethical guidelines. Participants will provide informed consent
before participating, with a guarantee of confidentiality and the right to withdraw from
the study at any time without penalty.
Significance
By rigorously evaluating these interventions, the study aims to provide clear,
evidence-based guidance on the most effective treatment strategies for managing DRA in
postpartum women. This research is crucial not only for enhancing individual patient care
but also for informing clinical practices and potentially influencing public health
policies related to maternal health and recovery.