Effects of Drawing in Maneuver and Resisted Ankle Dorsiflexion in Postpartum Diastasis Recti

April 2, 2026 updated by: Riphah International University

Combine Effects of Drawing in Maneuver and Resisted Ankle Dorsiflexion on Pain, Inter-recti Distance, Strength and Quality of Life in Postpartum Diastasis Recti

The aim of this study is to compare the combine effects of drawing in maneuver and resisted ankle dorsiflexion on pain, inter-recti distance, strength and quality of life in postpartum diastasis recti.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Randomized controlled research will assess how drawing-in maneuver and resisted ankle dorsiflexion together affect postpartum women with diastasis recti in terms of pain, inter-recti distance, abdominal strength, and quality of life. 20-40 years females from 6 weeks to 6 months to post-partum period will be included in this study and the data will be collected from Al Zahra Hospital, Ali medical center and Sharif Medical Complex. Two groups of 42 individuals will be randomly assigned to either the drawing-in maneuver alone (Group A, n = 21) or a combination of the drawing-in technique and resisted ankle dorsiflexion (Group B, n = 21). For six weeks, the intervention will be administered twice a week to both groups. Manual muscle testing for strength, caliper measurement for IRD, the SF-36 questionnaire for quality of life and the Numeric Pain Rating Scale (NPRS) for pain will all be used in baseline and post-treatment evaluations. The data will be analyzed using IBM SPSS Statistics version 25.

Study Type

Interventional

Enrollment (Estimated)

42

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Punjab Province
      • Gujranwala, Punjab Province, Pakistan, 52250
        • Recruiting
        • Al Zahra Hospital
        • Contact:
        • Principal Investigator:
          • Rida Zainab, MSPT(WH)

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Postpartum females (6 weeks to 6 months postpartum)
  • Diagnosed with diastasis recti (IRD ≥ 2.5 cm)
  • Age 20-45 years
  • Mode of delivery
  • Multiparity

Exclusion Criteria:

  • History of abdominal surgery
  • Pelvic organ prolapses
  • Neurological or orthopedic disorders
  • Presence of low back pain, hernia, or musculoskeletal disorders
  • Participation in any other abdominal rehabilitation program in the last 3 months

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: DRAWING IN MANEUVER & RESISTED ANKLE DORSIFLEXION
Drawing-In Maneuver (DIM), also known as the abdominal drawing-in maneuver, which is widely recognized as a foundational exercise for deep core activation
Other: DRAWING IN MANEUVER
Each contraction will be held for 10 seconds and repeated 10 times per session. This exercise will be performed two to three times per week for six weeks
Other: RESISTED ANKLE DORSIFLEXION
They will dorsiflex the ankle, pulling the toes toward the shin against the resistance, hold for 5-10 seconds, and then return to the starting position. Each leg will complete three sets of 10 repetitions, performed two to three times weekly
Active Comparator: DRAWING IN MANEUVER
Resisted Ankle Dorsiflexion contributes to core muscle engagement through kinetic chain activation.
Other: DRAWING IN MANEUVER
Each contraction will be held for 10 seconds and repeated 10 times per session. This exercise will be performed two to three times per week for six weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale
Time Frame: 6th week
This scale examines the subjective degree of pain severity is estimated using a horizontal line on a standardized self-reporting scale. The pain level is represented by an 11-point numerical scale. There is no pain (0), mild pain (1-2-3), moderate pain (4-5-6), and severe pain (7-8-9-10).
6th week
Caliper Measurement
Time Frame: 6th week
To assess inter-recti distance at reference points (above, at, and below the umbilicus) the caliper will be used. To measure inter-recti distance 4.5 cm above and below the umbilicus (indicated with skin markings), the inside jaws of the calipers are placed between the medial edges of the right and left rectus abdominis muscles as palpated by the examiner
6th week
Manual Muscle Testing (MMT)
Time Frame: 6th week
. Manual Muscle Testing (MMT) is a widely used clinical method to evaluate the strength of individual muscles or muscle groups on a standardized 0 to 5 scale. A grade of 0 indicates no visible or palpable muscle contraction, while 1 (Trace) denotes a slight muscle flicker without any movement. A grade 2 (Poor) means the muscle can complete full range of motion only when gravity is eliminated. Grade 3 (Fair) signifies the ability to move the joint through the full range of motion against gravity, but not against any resistance. Grade 4 (Good) indicates that the muscle can perform against moderate resistance, and grade 5 (Normal) represents full strength with the ability to resist maximal manual pressure
6th week
SF-36
Time Frame: 6th week
The SF-36 (Short Form-36 Health Survey) is a validated and reliable questionnaire used to assess health-related quality of life across eight domains, including physical functioning, bodily pain, general health, vitality, social functioning, and mental health. Each domain is scored from 0 to 100, with higher scores indicating better quality of life
6th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: hina gul, PhD*, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 1, 2025

Primary Completion (Estimated)

May 1, 2026

Study Completion (Estimated)

June 1, 2026

Study Registration Dates

First Submitted

April 2, 2026

First Submitted That Met QC Criteria

April 2, 2026

First Posted (Actual)

April 9, 2026

Study Record Updates

Last Update Posted (Actual)

April 9, 2026

Last Update Submitted That Met QC Criteria

April 2, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • REC/RCR&AHS/25/0504

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Diastasis Recti

Clinical Trials on DRAWING IN MANEUVER

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Australia

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe