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Effects of Barre-Based Core Stability With and Without Tupler Technique on Core Strength, Inter Recti Distance, and Pelvic Floor Function Among Diastasis Recti Abdominis Patients

This study will be a single blind, parallel group randomized controlled trial designed to evaluate the effectiveness of Barre-based core stability training with and without the Tupler Technique in postpartum women with Diastasis Recti Abdominis. A total of 58 eligible participants will be recruited from postpartum care units and randomly assigned in a 1:1 allocation ratio to either an experimental group receiving Barre-based core stability training combined with the Tupler Technique or a control group receiving Barre-based core stability training alone.

Both interventions will be delivered under supervised conditions three times per week for 8 weeks, with each session lasting approximately 30-45 minutes. The Barre-based program focuses on controlled low impact movements aimed at improving deep core muscle activation, postural alignment, and neuromuscular coordination. The experimental group will additionally receive the Tupler Technique, which includes abdominal splinting, progressive core strengthening exercises, and neuromuscular re-education targeting approximation of the rectus abdominis muscles and improved abdominal wall function.

Outcome measures include inter-recti distance, core strength, and pelvic floor function. Secondary outcomes include postural stability and functional performance. Assessments will be conducted at baseline, mid-intervention (week 4), post-intervention (week 8), and follow-up (week 12) by blinded outcome assessors to minimize bias.

The purpose of this trial is to determine whether combining the Tupler Technique with Barre-based core stability training provides superior improvements in abdominal separation, core strength, pelvic floor function, and functional ability compared with Barre-based training alone in postpartum women.

調査の概要

詳細な説明

Diastasis Recti Abdominis (DRA) is a postpartum musculoskeletal condition characterized by separation of the rectus abdominis muscles due to weakening of the linea alba, resulting in impaired core stability, reduced pelvic floor function, altered lumbopelvic mechanics, and decreased functional performance. Management is primarily conservative and involves exercise-based rehabilitation targeting abdominal wall integrity and neuromuscular control.

Barre-based core stability training is a low impact exercise intervention focusing on postural alignment, controlled movement, and activation of deep core musculature, including the transversus abdominis and pelvic floor muscles. The Tupler Technique is a structured rehabilitation program for DRA that includes abdominal splinting, progressive core strengthening, and neuromuscular re-education to improve rectus abdominis approximation and abdominal wall function.

This single blind, parallel group randomized controlled trial will recruit 58 postpartum women diagnosed with DRA. Participants will be randomly allocated using concealed assignment in a 1:1 ratio to either an experimental group receiving Barre-based core stability training combined with the Tupler Technique or a control group receiving Barre-based training alone.

Both groups will receive supervised interventions three times per week for 8 weeks, with each session lasting 30-45 minutes. The exercise protocol emphasizes controlled activation of deep core muscles, postural control, and safe functional movement patterns. The experimental group will additionally perform abdominal splinting and structured neuromuscular re-education as part of the Tupler Technique.

Outcome measures will include inter-recti distance, core strength, pelvic floor function, postural stability, and functional performance. Assessments will be conducted at baseline, week 4, week 8, and week 12 by blinded outcome assessors. Data will be analyzed to compare within group and between group changes over time, using appropriate statistical methods under an intention-to-treat approach.

The study evaluates whether adding the Tupler Technique to Barre-based core stability training provides superior improvements in abdominal separation, core stability, pelvic floor function, postural control, and functional ability in postpartum women with Diastasis Recti Abdominis.

研究の種類

介入

入学 (推定)

58

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

    • Punjab Province
      • Lahore、Punjab Province、パキスタン
        • 募集
        • Punjab Rangers Teaching Hospital (PRTH), Ghurki Trust Teaching Hospital (GTTH)
        • コンタクト:

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人

健康ボランティアの受け入れ

いいえ

説明

Inclusion Criteria

  • Women aged 18-40 years
  • Postpartum period between 6-12 months
  • Diagnosed with stage I-II Diastasis Recti Abdominis
  • Presence of symptoms such as abdominal weakness or back pain
  • Ability to follow exercise instructions Exclusion Criteria
  • Stage III Diastasis Recti Abdominis
  • Severe hernias or significant pelvic floor dysfunction
  • Neurological, cardiovascular, or systemic conditions contraindicating exercise
  • History of abdominal surgery or trauma affecting the abdominal wall

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:独身

武器と介入

参加者グループ / アーム
介入・治療
実験的:Barre-Based Core Stability with Tupler Technique (BBT+TT)
Participants will receive supervised Barre-based core stability training combined with the Tupler Technique. The Barre program will include low impact controlled exercises such as pelvic tilts, glute bridges, modified planks, lower limb core controlled movements, and functional standing exercises to improve deep core activation and postural control. The Tupler Technique component will include abdominal splinting, elevator exercises, and structured neuromuscular re-education aimed at reducing inter recti distance and improving abdominal wall integrity. Sessions will be conducted three times per week for 8 weeks, with each session lasting 30-45 minutes.
Barre-Based Core Stability Training is a low impact, structured exercise intervention designed to improve deep core muscle activation, postural alignment, and functional stability. It will include controlled movements such as pelvic tilts, glute bridges, modified planks, lower limb core-controlled exercises, and functional standing activities. The program will emphasize activation of the transversus abdominis and pelvic floor muscles through slow, controlled, and alignment focused exercises. Sessions will be conducted under supervision three times per week for 8 weeks, with each session lasting 30-45 minutes. This intervention will aim to enhance core strength, improve neuromuscular coordination, and support overall lumbopelvic stability.
The Tupler Technique is a structured rehabilitation program specifically designed for the management of Diastasis Recti Abdominis. It will include abdominal splinting, progressive core strengthening exercises, and neuromuscular re-education techniques. The program will focus on activating and strengthening the transversus abdominis while promoting approximation of the rectus abdominis muscles to reduce inter-recti distance. Key components will include elevator exercises, controlled core engagement, and the use of abdominal support during functional activities to enhance abdominal wall integrity. In this study, the Tupler Technique will be delivered in combination with Barre-based training over 8 weeks with supervised sessions three times per week.
アクティブコンパレータ:Barre-Based Core Stability Training (BBT)
Participants will receive supervised Barre-based core stability training alone. The program will include low-impact controlled exercises such as pelvic tilts, glute bridges, modified planks, lower limb core-controlled movements, and functional standing exercises aimed at improving deep core muscle activation, postural alignment, and functional stability. No Tupler Technique components such as abdominal splinting or neuromuscular re-education will be included. Sessions will be conducted three times per week for 8 weeks, with each session lasting 30-45 minutes.
Barre-Based Core Stability Training is a low impact, structured exercise intervention designed to improve deep core muscle activation, postural alignment, and functional stability. It will include controlled movements such as pelvic tilts, glute bridges, modified planks, lower limb core-controlled exercises, and functional standing activities. The program will emphasize activation of the transversus abdominis and pelvic floor muscles through slow, controlled, and alignment focused exercises. Sessions will be conducted under supervision three times per week for 8 weeks, with each session lasting 30-45 minutes. This intervention will aim to enhance core strength, improve neuromuscular coordination, and support overall lumbopelvic stability.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Inter-Recti Distance (IRD)
時間枠:Baseline (Day 0), Week 4, Week 8, Week 12
Inter-recti distance (IRD) will be measured to assess the separation of the rectus abdominis muscles in women with Diastasis Recti Abdominis. Measurements will be taken using ultrasound imaging and calipers at standardized anatomical points (above, at, and below the umbilicus). IRD will be recorded in centimeters. A reduction in IRD indicates improvement in abdominal wall integrity and core stability.
Baseline (Day 0), Week 4, Week 8, Week 12
Core Strength
時間枠:Baseline (Day 0), Week 4, Week 8, Week 12
Core strength will be assessed using the Modified Sahrmann Test, which evaluates lumbopelvic control and activation of deep core muscles during progressive lower limb movements. Performance will be scored based on the ability to maintain neutral spine alignment without compensatory movements such as pelvic tilt or abdominal bulging. Higher scores indicate better core strength and neuromuscular control.
Baseline (Day 0), Week 4, Week 8, Week 12
Pelvic Floor Function
時間枠:Baseline (Day 0), Week 4, Week 8, Week 12
Pelvic floor function will be assessed using the Pelvic Floor Distress Inventory (PFDI-20), a validated questionnaire measuring symptom severity related to urinary, colorectal, and prolapse distress. Scores range from 0 to 300, with higher scores indicating greater dysfunction. A reduction in score indicates improvement in pelvic floor function.
Baseline (Day 0), Week 4, Week 8, Week 12
Postural Stability
時間枠:Baseline (Day 0), Week 4, Week 8, Week 12
Postural Stability Postural stability will be assessed using the Balance Error Scoring System (BESS). Participants perform balance tasks in double-leg, single-leg, and tandem stance on firm and foam surfaces. Errors (e.g., stepping, loss of balance, opening eyes) are counted. Lower scores indicate better postural control.
Baseline (Day 0), Week 4, Week 8, Week 12
Functional Performance
時間枠:Baseline (Day 0), Week 4, Week 8, Week 12
Functional performance will be assessed using the Physical Functioning (PF-10) subscale of the SF-36 Health Survey. The scale evaluates limitations in activities such as walking, climbing stairs, lifting, and carrying objects. Scores range from 0 to 100, with higher scores indicating better functional ability.
Baseline (Day 0), Week 4, Week 8, Week 12

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:WHO、Lahore University of Biological and Applied Sciences

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年5月1日

一次修了 (推定)

2026年8月15日

研究の完了 (推定)

2026年10月15日

試験登録日

最初に提出

2026年7月23日

QC基準を満たした最初の提出物

2026年7月23日

最初の投稿 (実際)

2026年7月28日

学習記録の更新

投稿された最後の更新 (実際)

2026年7月28日

QC基準を満たした最後の更新が送信されました

2026年7月23日

最終確認日

2026年7月1日

詳しくは

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