Effectiveness of physiotherapy techniques for treating diastasis abdominis: A narrative systematic review
DOI:
https://doi.org/10.36105/psrua.2024v4n8.04Palabras clave:
técnicas, tratamiento, diástasis abdominal, fisioterapia, diastasis postparto, tratamiento no quirúrgicoResumen
Introducción: Durante el embarazo, el cuerpo experimenta cambios anatómicos y fisiológicos significativos, entre ellos la diástasis abdominal (AD), que implica la separación de los músculos rectos del abdomen. Este cambio puede causar inestabilidad lumbopélvica, dolor lumbar, mala postura, deficiencias pélvicas y pérdida de fuerza, además de aumentar el riesgo de hernias abdominales. La reconstrucción quirúrgica de la línea alba es el tratamiento estándar para la AD, pero las intervenciones de fisioterapia podrían ser una alternativa efectiva para controlar los síntomas y mejorar los resultados. Objetivo: Evaluar la efectividad de técnicas fisioterapéuticas para tratar la AD en mujeres posparto y determinar qué tratamiento reduce mejor la distancia entre los rectos abdominales. Material y métodos: Se realizó una revisión narrativa sistemática de 33 artículos seleccionados tras buscar en bases como PEDro, PubMed y ELSEVIER. Los estudios analizados incluían técnicas como ejercicios abdominales, fortalecimiento muscular, estabilidad profunda del core, kinesiotape, estimulación eléctrica neuromuscular y técnicas hipopresivas. Resultados: Los ejercicios abdominales, el fortalecimiento muscular y la estabilidad del core fueron las intervenciones más efectivas para tratar la AD. Conclusión: El ejercicio y la estabilidad del core son tratamientos fisioterapéuticos eficaces para la AD y pueden complementar los cuidados médicos habituales, mejorando los resultados y la calidad de vida de las mujeres en el posparto.
Descargas
PLUMX metrics
Citas
Williams obstetricia. México: McGraw-Hill; 2022.
Greenspan endocrinología básica y clínica. 10a ed. México: McGraw-Hill; 2019.
Morton DA. Anatomía macroscópica. México: McGraw-Hill; 2022.
Kim S, Yi D, Yim J. The Effect of Core Exercise Using Online Videoconferencing Platform and Offline-Based Intervention in Postpartum Woman with Diastasis Recti Abdominis. Int J Environ Res Public Health. 2022 Jun 8;19(12):7031. https://doi.org/10.3390/ijerph19127031
Boissonnault JS, Blaschak MJ. Incidence of Diastasis Recti Abdominis During the Childbearing Year. Phys Ther. 1988 Jul;68(7):1082-6. https://doi.org/10.1093/ptj/68.7.1082
Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med. 2016 Sep;50(17):1092-6. https://doi.org/10.1136/bjsports-2016-096065
Principios de cirugía. 11a ed. México, D.F.: McGraw-Hill; 2020.
PŻ, Dąbek A. Physiotherapy in women with diastasis of the rectus abdominis muscles. Adv Rehabil. 2018;32(3):11-7. DOI: https://doi.org/10.5114/areh.2018.80964
Beer GM, Schuster A, Seifert B, Manestar M, Mihic‐Probst D, Weber SA. The normal width of the linea alba in nulliparous women. Clin Anat. 2009 Sep;22(6):706-11. https://doi.org/10.1002/ca.20836
Pacheco FC, Espíndola KM, Rezende JR, Diniz JS, Aquino CFD. Contribution of the practice of resistance exercises and the type of delivery to the diastasis of the rectus abdominis muscles in primiparous women. Fisioter E Pesqui. 2023;30:e22006523en. https://doi.org/10.1590/1809-2950/e22006523en
Thabet AA, Alshehri MA. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial.
Kamel DM, Yousif AM. Neuromuscular Electrical Stimulation and Strength Recovery of Postnatal Diastasis Recti Abdominis Muscles. Ann Rehabil Med. 2017;41(3):465. https://doi.org/10.5535/arm.2017.41.3.465
Diagnóstico y tratamiento ginecoobstétricos. 12a ed. México, D.F.: McGraw-Hill Interamericana Editores, S.A. de C.V.; 2021.
Beer GM, Schuster A, Seifert B, Manestar M, Mihic‐Probst D, Weber SA. The normal width of the linea alba in nulliparous women. Clin Anat. 2009 Sep;22(6):706-11. https://doi.org/10.1002/ca.20836
Nahabedian M. Management Strategies for Diastasis Recti. Semin Plast Surg. 2018 Aug;32(3):147-54. https://doi.org/10.1055/s-0038-1661380
Reinpold W, Köckerling F, Bittner R, Conze J, Fortelny R, Koch A, et al. Classification of Rectus Diastasis—A Proposal by the German Hernia Society (DHG) and the International Endohernia Society (IEHS). Front Surg. 2019 Jan 28;6:1. https://doi.org/10.3389/fsurg.2019.00001
Hernández-Granados P, Henriksen NA, Berrevoet F, Cuccurullo D, López-Cano M, Nienhuijs S, et al. European Hernia Society guidelines on management of rectus diastasis. Br J Surg. 2021 Oct 23;108(10):1189-91. https://doi.org/10.1093/bjs/znab128
Keramidas E, Rodopoulou S, Gavala MI. A Proposed Classification and Treatment Algorithm for Rectus Diastasis: A Prospective Study. Aesthetic Plast Surg. 2022 Oct;46(5):2323-32. https://doi.org/10.1007/s00266-021-02739-w
Stedge HL, Medina McKeon JM. A Supervised Pelvic Floor Training Program Has Minimal Effect on the Prevalence of Postpartum Diastasis Recti Abdominis: A Critically Appraised Paper. Int J Athl Ther Train. 2020 Nov 1;25(6):299-302. https://doi.org/10.1123/ijatt.2019-0112
Lee N, Bae YH, Fong SSM, Lee WH. Effects of Pilates on inter-recti distance, thickness of rectus abdominis, waist circumference and abdominal muscle endurance in primiparous women. BMC Womens Health. 2023 Nov 27;23(1):626. https://doi.org/10.1186/s12905-023-02775-5
Gillard S, Ryan C, Stokes M, Warner M, Ewings S, Dixon J. Immediate effects of lateral abdominal muscle exercise in different postural positions on the inter-recti distanc e in parous women. Physiotherapy. 2019 Jan;105:e14.
Mumtaz SN, Kayani BA, Shah SF, Shah SH. Role of Exercise in Preventing Diastasis Recti in Pregnant Women. Pak Armed Forces Med J. 2022 Feb 28;72(1):198-201. https://doi.org/10.51253/pafmj.v72i1.4053
LaFramboise FC, Schlaff RA, Baruth M. Postpartum Exercise Intervention Targeting Diastasis Recti Abdominis. 2021. https://doi.org/10.70252/GARZ3559
Gluppe SL, Hilde G, Tennfjord MK, Engh ME, Bø K. Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial. Phys Ther. 2018 Apr 1;98(4):260-8. https://doi.org/10.1093/ptj/pzy008
Vesting S, Gutke A, Fagevik Olsén M, Rembeck G, Larsson MEH. The Impact of Exercising on Pelvic Symptom Severity, Pelvic Floor Muscle Strength, and Diastasis Recti Abdominis After Pregnancy: A Longitudinal Prospective Cohort Study. Phys Ther. 2024 Apr 2;104(4):pzad171. https://doi.org/10.1093/ptj/pzad171
Gluppe SB, Ellström Engh M, Bø K. Curl-up exercises improve abdominal muscle strength without worsening inter-recti distance in women with diastasis recti abdominis postpartum: a randomised controlled trial. J Physiother. 2023 Jul;69(3):160-7. doi: 10.1016/j.jphys.2023.05.017
Shohaimi S, Husain NRN, Zaki FM, Atan IK. Split Tummy Exercise Program for Reducing Diastasis Recti in Postpartum Primigravidae: A Randomized Controlled Trial. Korean J Fam Med. 2023 Mar 20;44(2):102-8. doi: 10.4082/kjfm.22.0035
Theodorsen NM, Moe-Nilssen R, Bø K, Haukenes I. Effect of exercise on the inter-rectus distance in pregnant women with diastasis recti abdominis: an experimental longitudinal study. Physiotherapy. 2023 Dec;121:13-20. doi: 10.1016/j.physio.2023.08.001
Theodorsen NM, Strand LI, Bø K. Effect of pelvic floor and transversus abdominis muscle contraction on inter-rectus distance in postpartum women: a cross-sectional experimental study. Physiotherapy. 2019 Sep;105(3):315-20. doi: 10.1016/j.physio.2018.08.009
Djivoh YS, De Jaeger D. Acute effect of Sit-up versus Curl-up on the interrecti distance: A cross-sectional study in parous women. Prog En Urol. 2022 Sep;32(11):776-83. doi: 10.1016/j.purol.2022.07.140
Theodorsen NM, Fersum KV, Moe-Nilssen R, Bo K, Haukenes I. Effect of a specific exercise programme during pregnancy on diastasis recti abdominis: study protocol for a randomised controlled trial. BMJ Open. 2022 Feb;12(2):e056558. doi: 10.1136/bmjopen-2021-056558
Kaya AK, Menek MY. Comparison of the efficiency of core stabilization exercises and abdominal corset in the treatment of postpartum diastasis recti abdominis. Eur J Obstet Gynecol Reprod Biol. 2023 Jun;285:24-30. doi: 10.1016/j.ejogrb.2023.03.040
Keshwani N, Mathur S, McLean L. The impact of exercise therapy and abdominal binding in the management of diastasis recti abdominis in the early post-partum period: a pilot randomized controlled trial. Physiother Theory Pract. 2021 Sep 2;37(9):1018-33. doi: 10.1080/09593985.2019.1675207
Gluppe SB, Engh ME, Bø K. Immediate Effect of Abdominal and Pelvic Floor Muscle Exercises on Interrecti Distance in Women With Diastasis Recti Abdominis Who Were Parous. Phys Ther. 2020 Aug 12;100(8):1372-83. doi: 10.1093/ptj/pzaa070
Tadmare S, Bhatnagar G, Kamble R, Phad SG, Landge KM. Comparison of abdominal exercises and neuromuscular electrical stimulation on diastasis recti abdominis muscle in postnatal females with caesarean section.
Situt G, Kanase S. Effectiveness of NMES and Taping on Diastasis Recti in Postnatal Women. J Ecophysiol Occup Health. 2021 Sep 20;21(3):105. DOI:10.18311/jeoh/2021/28267
Darwish DS, Bleedy NK, Elhosary EA, Ebeed AI, Salem SE, Elshamy F. Prone plank exercises versus electrical stimulation for the treatment of diastasis rectus abdominis in postpartum women. DOI:10.14198/jhse.2021.16.Proc2.24
Liang P, Liang M, Shi S, Liu Y, Xiong R. Rehabilitation programme including EMG-biofeedback-assisted pelvic floor muscle training for rectus diastasis after childbirth: a randomised controlled trial. Physiotherapy. 2022 Dec;117:16-21.
Afzal U, Saeed Q, Anwar MN, Pervaiz S, Shahid M, Javed R, et al. Comparison of Health Parameters in Postpartum Diastasis Recti: A Randomized Control Trial of SEMG Biofeedback-Assisted Core Strengthening Exercises with Kinesiotaping vs. Non-Assisted Exercises. Healthcare. 2024 Aug 7;12(16):1567. https://doi.org/10.3390/healthcare12161567
Ptaszkowska L, Gorecka J, Paprocka-Borowicz M, Walewicz K, Jarzab S, Majewska-Pulsakowska M, et al. Immediate Effects of Kinesio Taping on Rectus Abdominis Diastasis in Postpartum Women—Preliminary Report. J Clin Med. 2021 Oct 28;10(21):5043. doi: 10.3390/jcm10215043
Jobanputtra Y, Patil S. Immediate Effect of Kinesio-Taping on Lumbopelvic Stability in Postpartum Women With Diastasis Recti: A Review. doi: 10.7759/cureus.33347
Da Cuña-Carrera I, Soto-González M, Alonso-Calvete A, González-González Y, Lantarón-Caeiro EM. Immediate effects of different types of abdominal exercises on the inter-rectus distance. Isokinet Exerc Sci. 2021 Feb 1;29(1):31-7. DOI:10.3233/IES-203161
Arranz-Martín B, Navarro-Brazález B, Sánchez-Sánchez B, McLean L, Carazo-Díaz C, Torres-Lacomba M. The Impact of Hypopressive Abdominal Exercise on Linea Alba Morphology in Women Who Are Postpartum: A Short-Term Cross-Sectional Study. Phys Ther. 2022 Aug 4;102(8):pzac086. doi: 10.1093/ptj/pzac086
Liu Y, Zhu Y, Jiang L, Lu C, Xiao L, Chen J, et al. Efficacy of Acupuncture in Post-partum With Diastasis Recti Abdominis: A Randomized Controlled Clinical Trial Study Protocol. Front Public Health. 2021 Dec 13;9:722572. doi: 10.3389/fpubh.2021.722572
Kirk B, Elliott-Burke T. The effect of visceral manipulation on Diastasis Recti Abdominis (DRA): A case series. J Bodyw Mov Ther. 2021 Apr;26:471-80. doi: 10.1016/j.jbmt.2020.06.007
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2024 Natalie Fastag Weber, Begoña Maciel Cámara, Vivian Dichi Michan, Moisés Jonathan Magos Chong, Artemio Efraim Cruz Vélez, Irlanda Olvera Gómez
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Todo el contenido intelectual que se encuentra en la presente publicación periódica se licencia al público consumidor bajo la figura de Creative Commons©, salvo que el autor de dicho contenido hubiere pactado en contrario o limitado dicha facultad a “Proceedings of Scientific Research Universidad Anáhuac. Multidisciplinary Journal of Healthcare©” o “Universidad Anáhuac México©” por escrito y expresamente.
Proceedings of Scientific Research Universidad Anáhuac. Multidisciplinary Journal of Healthcare se distribuye bajo una Licencia Creative Commons Reconocimiento-No comercial-Sin derivados 4.0 Internacional (CC BY-NC-ND 4.0).
El autor conserva los derechos patrimoniales sin restricciones y garantiza a la revista el derecho de ser la primera publicación del trabajo. El autor es libre de publicar en cualquier otro medio su artículo, como un repositorio institucional.
