Effects of Tupler's Technique on the Management of Diastasis Rectus Abdominis.

Effects of Tupler's Technique on the Management of Diastasis Rectus Abdominis in Post-Partum Females.

Diastasis Rectus Abdominis is the condition in which two abdominal muscles rectus abdominis separated and cause widening and thinning of Linea alba. The Tupler's Technique is Evidence Based intervention for the management of Diastasis Rectus Abdominis. The purpose of this study is to see the Effectiveness of Tupler's Technique on the Management of Diastasis Rectus Abdomins in Post-Partum Females.

Study Overview

• Status: Completed
• Conditions: Diastasis Rectus Abdominis
• Intervention / Treatment: Other: Tupler's Technique; Other: Traditional Exercises

Detailed Description

Literature suggest that during pregnancy due to hormonal changes such as increased in Relaxin, estrogen and progesterone level and also increased in the size of uterus affect the aponeurosis connection of abdominal muscles and due to these changes Diastasis Rectus Abdominis is common during pregnancy especially in third trimester and in the post-partum period. we can measure diastasis rectus abdominis by different methods such as palpatory, caliper and ultrasound. The condition can be mild (two fingers gap), moderate (two to three fingers gap) and severe (more than three fingers gap). The separation of greater than 2cm is considered as Diastasis Rectus Abdominis.

In this study effectiveness of Tupler's Technique will be assessed in post-partum diastasis rectus abdominis patients. Patients will have to wear diastasis rehab splints and then perform tupler's technique exercises. The mechanism behind this is when patients wear splint the splint will keep the connective tissues in narrow position for better healing and strengthening of muscles will be done by Tuper's Technique exercises and Diastasis of Rectus Abdominis willl be treated.

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Faisalābad, Punjab, Pakistan, 38000
      • Allied Hospital Faisalabad
    • Faisalābad, Punjab, Pakistan, 38000
      • Madinah Teaching Hospital Faisalabad

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Primiparous and multiparous females (Vaginal delivery).
• Greater than and equal to 12 weeks post-partum
• Age limit will be18-30 years
• BMI under or equa to 29kg/m2
• Visiting with the complain of low back pain
• Diastasis of rectus abdominis at the level of umbilicus with mild, moderate and severe condition.

Exclusion Criteria:

• Other musculoskeletal disease (disc prolapse and disc bulge)
• Trauma of bowel and bladder
• Heart and respiratory conditions including sneezing and excessive coughing
• Any pelvic floor, abdominal and spinal surgery

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Interventional Group; Tupler's Technique will be applied to this group. This technique includes Tupler's technique exercises and patients will also wears diastasis rehab splints. Patients will perform seated isometric exercises (elevator and contracting exercises) after wearing diastasis rehab splint. Repetitions of exercises will be 100 and whole intervention will be provided for 6 weeks.	Other: Tupler's Technique; Patient will wear diastasis rehab splint and will follow Tupler's techniqe protocol for 6 weeks. In the first 2 weeks both elevator and contracting exercises will be performed and after 2 weeks in the 3rd week only contracting exercises will be perform and for these exercises we divide abdomen into 6 floors and will patient have to contract her tummy towards the 3rd to 5th floor in first week, towards the 4th to 5th floor in 2nd week and from 5th to 6th floor in the 3rd week. in the wek 4 to week 6 head lifts will also be started along with contracting exercises from 5th to 6th floor.
Active Comparator: Control Group; Traditional treatment protocol will be applied to this group that includes traditional exercises for diastasis rectus abdominis and this protocol will be followed 3 times per week for 6 weeks.	Other: Traditional Exercises; The traditional treatment includes traditional abdominal exercises that patient will be perform for 6 weeks and three times per week with 15 repetitions of each exercise. These exercises includes posterior pelvic tilt' static abdominal contractions', reverse sit up exercise, kegals, russian twist , trunk twist and reverse trunk twist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Digital nylon caliper to measure inter-recti Distance	Digital nylon caliper is the valid and reliable instrument to measure the inter-recti distance and inter-recti distance will be measured at three levels. at the level of umbilicus, 4.5cm above umbilicus and 4.5cm below umbilicus.	Before intervention, after 3 weeks and after 6 weeks.
Oswestry low bac pain disability Questionnaire	This is a valid tool to assess back pain and this questionnaire has 10 sections and we grade level of disability according to grading criteria. 0-4shows no disability, 5-14 shows mild disability, and 15-24 shows moderate disability, and 25-34 shows severe disability and grade 35-50 means completely disabled.	Before intervention, after 3 weeks and after 6 weeks.
Numeric Pain rating scale	By using this scale we will measure the intensity of back pain. i scores pain from 0-10. 0 means no pain, 5 means moderate pain and 10 means severe pain.	Before intervention, after 3 weeks and after 6 weeks.
Maternal post-partum quality of life instrument (MPQOL-I)	This questionnaire has 5 domains. psychological, reltion with family and friends, relation with spouse, socioeconomic and health related domain and we can assess every domain of female life.	Before intervention, after 3 weeks and after 6 weeks.

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Study Chair: Huma Riaz, PhD, Riphah International University, Islamabad, Pakistan; Principal Investigator: Aqsa Shahid, MSPT*, Riphah International University, Islamabad, Pakistan

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2024
• Primary Completion (Actual): December 31, 2024
• Study Completion (Actual): December 31, 2024

Study Registration Dates

• First Submitted: July 28, 2024
• First Submitted That Met QC Criteria: July 28, 2024
• First Posted (Actual): July 31, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 20, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: Diastasis Rectus Abdominis; Post-Partum Period; Tupler's Technique; Abdominal Strength
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Wounds and Injuries; Joint Diseases; Joint Dislocations; Diastasis, Muscle
• Other Study ID Numbers: Aqsa Shahid

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No