Effects of Corrective Versus Plank Exercises on Diastasis Recti
Effects of Corrective Versus Plank Exercises on Strength, Inter Recti Distance and Pain in Females With Diastasis Recti
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Imran Amjad, PhD
- Phone Number: 03324390125
- Email: imran.amjad@riphah.edu.pk
Study Locations
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Punjab Province
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Lahore, Punjab Province, Pakistan, 6400
- Recruiting
- Services Hospital
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Contact:
- adeela arif, t-DPT
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Principal Investigator:
- Fazeela Tahir, MSPT(WH)
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- If IRD is greater than 4cm and above
- Postpartum females
- Three months to three years postpartum with presence of diastasis rectus abdominis
- Vaginal delivery
- Multiparous
- Pain greater than 6 on NPRS
Exclusion Criteria:
- Subjects with any heart condition, respiratory condition
- Any pelvic or abdominal surgery
- Any neurological disease eg preeclampsia, epilepsy
- Trauma to bowel or bladder
- Prior history of physical therapy treatment for pelvic floor issues
- Postpartum depression
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: corrective exercises
During weeks 1-4, the program emphasized low-load activation, including transversus abdominis (TrA) drawing-in activation, posterior pelvic tilting, and modified heel slides performed with strict abdominal control.
In weeks 5-8, progression was achieved through increased hold times, higher repetitions, slower tempo, and the gradual introduction of light resistance or functional integration cues where tolerated.
In weeks 9-12, participants progressed toward functional core integration and advanced control exercises such as dead bug variations,
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restoration of trunk stability, and reduction of IRD through improved tensioning of the linea alba.
During weeks 1-4, the program emphasized low-load activation, including transversus abdominis (TrA) drawing-in activation, posterior pelvic tilting, and modified heel slides performed with strict abdominal control.
In weeks 5-8, progression was achieved through increased hold times, higher repetitions, slower tempo, and the gradual introduction of light resistance or functional integration cues where tolerated.
In weeks 9-12, participants progressed toward functional core integration and advanced control exercises such as dead bug variations,
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Experimental: PLANK EXERCISES
In weeks 1-4, the program began with modified plank positions using knee-and-elbow support and modified side planks, with short hold durations and adequate rest intervals.
During weeks 5-8, hold times were progressively increased, and participants were introduced to controlled plank variations such as weight-shifts or arm reach tasks depending on tolerance and maintenance of neutral spine control.
In weeks 9-12, progression was aimed toward longer holds and more advanced stabilization tasks, including leg lifts in plank and progression toward full plank positions
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In weeks 1-4, the program began with modified plank positions using knee-and-elbow support and modified side planks, with short hold durations and adequate rest intervals.
During weeks 5-8, hold times were progressively increased, and participants were introduced to controlled plank variations such as weight-shifts or arm reach tasks depending on tolerance and maintenance of neutral spine control.
In weeks 9-12, progression was aimed toward longer holds and more advanced stabilization tasks, including leg lifts in plank and progression toward full plank positions
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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NPRS
Time Frame: 12th week
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The Numerical Pain Rating Scale (NPRS) is a subjective measure in which individuals rate their pain on an eleven-point numerical scale.
The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain.
The NPRS is a widely used patient reported outcome scale.27-29
The ordinal 11-point NPRS (0-no pain, 10-most intense pain) is the most commonly used version which has good test-retest reliability (r=.79-.96) in individuals with chronic pain and musculoskeletal pathology.
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12th week
|
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• MMT
Time Frame: 12th week
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MMT is the most commonly used method for documenting impairments in muscle strength.
Manual muscle testing is used in rehabilitation and recovery to evaluate contractile units, including muscles and tendons, and their ability to generate forces.
Reliability of strength MMT grade of lower extremity is 66-0.90.
There are six grades of MMT i.e.
Grade 5 (Normal), Grade 4 (Good), Grade 3+ (Fair), Grade 2+ (Poor), Grade 1 (Trace) and Grade 0 (Zero)
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12th week
|
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inter-recti distance
Time Frame: 12th week
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The subjects were in supine resting position with the knees bent at 90° and feet resting on the plinth, arms alongside the body.
After instruction in how to perform an abdominal crunch the subjects were asked to raise the head and shoulders upwards until the shoulder blades cleared the table.
One physiotherapist placed the fingers vertically on the subject's Linea Alba in a way that fingers widths could fit the distance between the internal borders of the two rectus abdominis muscles.
Using the center of the umbilicus as a reference, measurements were taken in two previously marked locations: one being 2 cm above the umbilicus and the other being 2 cm below the umbilicus.
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12th week
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Oswestry Disability Index
Time Frame: 12th week
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The Oswestry Disability Index (ODI) is defined as a validated metric that assesses a patient's perceived level of disability through a 10-question assessment, yielding a numerical score from 0 to 100, where higher scores indicate greater disability
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12th week
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: adeela arif, t-DPT, Riphah International University
Publications and helpful links
General Publications
- Gluppe S, Engh ME, Bo K. What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis. Braz J Phys Ther. 2021 Nov-Dec;25(6):664-675. doi: 10.1016/j.bjpt.2021.06.006. Epub 2021 Jul 21.
- Abdullah, Rehman KA, Ahmad B, Arshad MK, Saeed H, Keen MA, Anwar A, Saleem NUA, Salma Shabbar Banatwala UE, Bilal Z, Shahzad M, Shakoor P, Niazi MA. Comparative Efficacy of Abdominal Exercises and Abdominal Binding on Diastasis Recti Abdominis Reduction in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Physiother Res Int. 2025 Apr;30(2):e70038. doi: 10.1002/pri.70038.
- Benjamin DR, Frawley HC, Shields N, Peiris CL, van de Water ATM, Bruder AM, Taylor NF. Conservative interventions may have little effect on reducing diastasis of the rectus abdominis in postnatal women - A systematic review and meta-analysis. Physiotherapy. 2023 Jun;119:54-71. doi: 10.1016/j.physio.2023.02.002. Epub 2023 Mar 5.
- Berg-Poppe P, Hauer M, Jones C, Munger M, Wethor C. Use of Exercise in the Management of Postpartum Diastasis Recti: A Systematic Review. Journal of Women's Health Physical Therapy. 2022.
- Toprak Celenay S, Balaban M, Ozer Kaya D. Immediate effects of corrective exercise versus curl-up in women with diastasis recti abdominis. J Bodyw Mov Ther. 2024 Oct;40:1610-1614. doi: 10.1016/j.jbmt.2024.08.011. Epub 2024 Aug 15.
- Cuña-Carrera ID, Soto-González M, Alonso-Calvete A, González-González Y, Lantarón-Caeiro E. Immediate effects of different types of abdominal exercises on the inter-rectus distance. Isokinetics and exercise science. 2021
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- REC/RCR&AHS/24/0536
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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