Effects of hypopressiveexercises on post-partum abdominal diastasis, trunk circumference and mechanical properties of abdominopelvic tissues: a case series

Abstract

Background: Abdominal diastasis (AD) is highly prevalent at post-partum. Although several conservative approaches have been proposed, an effective and protocolized treatment is lacking for this condition. Objective: To identify modifications of inter-rectus abdominis distance (IRAD), trunk circumferences and mechanical properties of the AD, transversus abdominis and the pelvic floor (PF) muscles, after the application of hypopressive exercises (HE) and at a two-monthsfollow-up in postpartum AD. Methods: Twelve volunteers with post-partum AD followed a four-week (three times a week) tailored program of HE. The main outcome was the IRAD, assessed at four specific supraumbilical points (3, 6, 9 and 12 cm). Abdominal circumference and respiratory expansion were measured at three different locations (axillar, xiphoid and umbilical), and the mechanical properties of abdomino-pelvic tissues were also assessed using tonometry (MyotonPRO). Four evaluations were performed for all outcomes: at baseline, post-intervention, at a 1-month follow-up, and at a 2-month follow-up. Results: The IRAD of participants was reduced (p<0.05), furthermore, some participants displayed no AD after the intervention period. In addition, the abdominal circumference increased, mainly at follow-up, whereas the thoracic respiratory expansion decreased a median of 2cm. The tension and stiffness of the LA decreased, when assessed at 3 and 6 cm supraumbilical. Finally, the tension and elasticity of TA/IO and of the PF, and also the elasticity of the PF decreased after the intervention period. No complaints were identified in relation to the HE program or assessments. Conclusion: A program of HE showed positive results for the reduction of post-partum AD. Different study designs should be performed to better explain the effects of HE for AD.