Effectiveness of Pilates-based exercises on the diastasis recti abdominis in climacteric women: a randomized controlled trial

Main Article Content

Elaine Priscila Garcia Silva
Thainá Tolosa de Bortolli
Giovana Vesentini
Gabriela Marini

Abstract

Introduction: Recent studies have related the climacteric period with changes in connective tissue elasticity that may be related to diastasis recti abdominis. Mat Pilates is a method of exercise without impact that currently has more practitioners, due to its satisfactory results. However, there are no studies that evaluate the effectiveness of mat Pilates for women with diastasis recti abdominis. Objective: To evaluate the effectiveness of the mat Pilates program in climacteric women with diastasis recti abdominis. Methods: This randomized single-blinded clinical trial evaluated climacteric women with diastasis recti abdominis. The participants were randomized into the experimental group, which participated in 3 weekly sessions of mat Pilates for 12 weeks for a total of 36 sessions, and the control group (without exercises). The inter-rectus distance was measured with a digital caliper. The G*Power Version 3.1.9.2. software was used for the sample calculation, and the SPSS 20.0 program was used for statistical analysis. Results: The study comprised 21 women, including 10 in the control group and 11 in the experimental group, with mean ages of 54.3 ± 7.1 and 55.3 ± 6.0 years and body mass index values of 28.8 ± 5.5 kg/m2 and 29.9 ± 4.48 kg/m2, respectively. In the experimental group, reductions were observed in all the measures related to diastasis recti abdominis (p<0.05) in the supraumbilical, umbilical, and infra-umbilical regions. Conclusion: The mat Pilates method is effective for reducing diastasis recti abdominis in the climacteric period.

Downloads

Download data is not yet available.

Article Details

How to Cite
Silva, E. P. G., Bortolli, T. T. de, Vesentini, G., & Marini, G. (2024). Effectiveness of Pilates-based exercises on the diastasis recti abdominis in climacteric women: a randomized controlled trial. ABCS Health Sciences. https://doi.org/10.7322/abcshs.2022071.2135
Section
Original Articles

References

Liaw LJ, Hsu MJ, Liao CF, Liu MF, Hsu AT. The relationships between inter-recti distance measured by ultrasound imaging and abdominal muscle function in postpartum women: a 6-month follow-up study. J Orthop Sports Phys Ther. 2011;41(6):435-43. https://doi.org/10.2519/jospt.2011.3507

Hills NF, Graham RB, McLean L. Comparison of trunk muscle function between women with and without diastasis recti abdominis at 1 year postpartum. Phys Ther. 2018;98(10):891-901. https://doi.org/10.1093/ptj/pzy083

Spitznagle TM, Leong FC, Van Dillen LR. Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(3):321-8. https://doi.org/10.1007/s00192-006-0143-5

Kaufmann RL, Reiner CS, Dietz UA, Clavien PA, Vonlanthen R, Käser SA. The normal width of the linea alba, prevalence, and risk factors for diastasis recti abdominis in adults, a cross-sectional study. Hernia. 2022;26(2):609-18. https://doi.org/10.1007/s10029-021-02493-7

Hickey F, Finch JG, Khanna A. A systematic review on the outcomes of correction of diastasis of the recti. Hernia. 2011;15(6):607-14. https://doi.org/10.1007/s10029-011-0839-4

Carlstedt A, Bringman S, Egberth M, Emanuelsson P, Olsson A, Petersson U, et al. Management of diastasis of the rectus abdominis muscles: recommendations for Swedish national guidelines. Scand J Surg. 2021;110(3):452-9. https://doi.org/10.1177/1457496920961000

Keeler J, Albrecht M, Eberhardt L, Horn L, Donnelly C, Lowe D. Diastasis Recti Abdominis: A Survey of Women's Health Specialists for Current Physical Therapy Clinical Practice for Postpartum Women. J Womens Health Phys Therap. 2012;36(3):131-42. https://doi.org/10.1097/JWH.0b013e318276f35f

Gluppe SL, Hilde G, Tennfjord MK, Engh ME, Bø K. Effect of a Postpartum training program on prevalence of diastasis recti abdominis in postpartum primiparous women: a randomized controlled trial. Phys Ther. 2018;98(4):260-8. https://doi.org/10.1093/ptj/pzy008

Wells C, Kolt GS, Bialocerkowski A. Defining Pilates exercise: a systematic review. Complement Ther Med. 2012;20(4):253-62. https://doi.org/10.1016/j.ctim.2012.02.005

Oliveira LC, Oliveira RG, Pires-Oliveira DAA. Effects of Pilates on muscle strength, postural balance, and quality of life of older adults: a randomized, controlled, clinical trial. J Phys Ther Sci. 2015;27(3):871-6. https://doi.org/10.1589/jpts.27.871

Hita-Contreras F, Martínez-Amat A, Cruz-Díaz D, Pérez-López FR. Fall prevention in postmenopausal women: the role of Pilates exercise training. Climacteric. 2016;19(3):229-33. https://doi.org/10.3109/13697137.2016.1139564

Küçükçakır N, Altan L, Korkmaz N. Effects of Pilates exercises on pain, functional status, and quality of life in women with postmenopausal osteoporosis. J Bodyw Mov Ther. 2013;17(2):204-11. https://doi.org/10.1016/j.jbmt.2012.07.003

Culligan PJ, Scherer J, Dyer K, Priestley JL, Guingon-White G, Delvecchio D, et al. A randomized clinical trial comparing pelvic floor muscle training to a Pilates exercise program for improving pelvic muscle strength. Int Urogynecol J. 2010;21(4):401-8. https://doi.org/10.1007/s00192-009-1046-z

Cruz-Diaz D, Martínez-Amat A, Osuna-Pérez MC, De la Torre-Cruz MJ, Hita-Contreras F. Short- and long-term effects of a six-week clinical Pilates program in addition to physical therapy on postmenopausal women with chronic low back pain: a randomized controlled trial. Disabil Rehabil. 2016;38(13):1300-8. https://doi.org/10.3109/09638288.2015.1090485

Muscolino JE, Cipriani S. Pilates and the “powerhouse”—I. J Bodywork Mov Ther. 2004;8(1):15-24. https://doi.org/10.1016/S1360-8592(03)00057-3

Souza ROB, Marcon LF, Arruda ASF, Pontes Junior FL, Melo RC. Effects of mat pilates on physical functional performance of older adults: a meta-analysis of randomized controlled trials. Am J Phys Med Rehabil. 2018;97(6):414-25. https://doi.org/10.1097/PHM.0000000000000883

Mendo H, Jorge MSG. Método Pilates e a dor na gestação: revisão sistemática e meta-análise. Br JP. 2021;4(3):276-82.

Gluppe SL, Hilde G, Tennfjord MK, Engh ME, Bø K. Effect of a postpartum training program on the prevalence of diastasis recti abdominis in postpartum primiparous women: a randomized controlled trial. Phys Ther. 2018;98(4):260-8. https://doi.org/10.1093/ptj/pzy008

Boxer S, Jones S. Intra-rater reliability of rectus abdominis diastasis measurement using dial calipers. Aust J Physiother. 1997;43(2):109-14. https://doi.org/10.1016/s0004-9514(14)60405-0

Chiarello CM, McAuley JA. Concurrent validity of calipers and ultrasound imaging to measure inter recti distance. J Orthop Sports Phys Ther. 2013;43(7):495-503. https://doi.org/10.2519/jospt.2013.4449

Rath AM, Attali P, Dumas JL, Goldlust D, Zhang J, Chevrel JP. The abdominal linea alba: an anatomo-radiologic and biomechanical study. Surg Radiol Anat. 1996;18(4):281-8. https://doi.org/10.1007/BF01627606

Chiarello CM, Falzone LA, McCaslin KE, Patel MN, Ulery KR. The effects of an exercise program on diastasis recti abdominis in pregnant women. J Women’s Health Phys Ther. 2005;29(1):11-16.

Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med. 2016;50(17):1092-6. https://doi.org/10.1136/bjsports-2016-096065

Bø K, Hilde G, Tennfjord MK, Sperstad JB, Engh ME. Pelvic floor muscle function, pelvic floor dysfunction, and diastasis recti abdominis: Prospective cohort study. Neurourol Urodyn. 2017;36(3):716-21. https://doi.org/10.1002/nau.23005

Sipilä S, Törmäkangas T, Sillanpää E, Aukee P, Kujala UM, Kovanen V, et al. Muscle and bone mass in middle-aged women: role of menopausal status and physical activity. J Cachexia Sarcopenia Muscle. 2020;11(3):698-709. https://doi.org/10.1002/jcsm.12547

Di Lorenzo CE. Pilates: what is it? Should it be used in rehabilitation? Sports Health. 2011;3(4):352-61. https://doi.org/10.1177/1941738111410285

Mackey AL, Magnan M, Chazaud B, Kjaer M. Human skeletal muscle fibroblasts stimulate in vitro myogenesis and in vivo muscle regeneration. J Physiol. 2017;595(15):5115-27. https://doi.org/10.1113/JP273997

Lee DG, Lee LJ, McLaughlin L. Stability, continence, and breathing: the role of fascia following pregnancy and delivery. J Bodyw Mov Ther. 2008;12(4):333-48. https://doi.org/10.1016/j.jbmt.2008.05.003

Zappile-Lucis M. Quality of life measurements and physical therapy management of a female diagnosed with diastasis recti abdominis. J Women’s Health Phys Ther. 2009;33(1):22.

Oliveira LC, Oliveira RG, Pires-Oliveira DAA. Pilates increases the isokinetic muscular strength of the knee extensors and flexors in elderly women. J Bodyw Mov Ther. 2017;21(4):815-22. https://doi.org/10.1016/j.jbmt.2017.01.006

Carrasco-Poyatos M, Ramos-Campo DJ, Rubio-Arias JA. Pilates versus resistance training on trunk strength and balance adaptations in older women: a randomized controlled trial. Peer J. 2019;7:e7948. https://doi.org/10.7717/peerj.7948

Nightingale G, Chandrakumaran K, Phillips C. The effect of modified Pilates-based positions on pelvic floor electromyographic (EMG) activity; a pilot study. Int Urogynecol J. 2021;32(2):287-92. https://doi.org/10.1007/s00192-020-04529-5

Sapsford RR, Hodges PW. Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehabil. 2001;82(8):1081-8. https://doi.org/10.1053/apmr.2001.24297

Vesentini G, El Dib R, Righesso LAR, Piculo F, Marini G, Ferraz GAR, et al. Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis. Clinics (Sao Paulo). 2019;74:e1319. https://doi.org/10.6061/clinics/2019/e1319

Bø K, Hilde G, Tennfjord MK, Sperstad JB, Engh ME. Pelvic floor muscle function, pelvic floor dysfunction, and diastasis recti abdominis: Prospective cohort study. Neurourol Urodyn. 2017;36(3):716-21. https://doi.org/10.1002/nau.23005

Mesquita LA, Machado AV, Andrade AV. Physiotherapy for reduction of diastasis of the recti abdominis muscles in the postpartum period. Rev Bras Ginecol Obstet. 1999;21(5):267-72. https://doi.org/10.1590/S0100-72031999000500004

Walton LM, Costa A, LaVanture D, McIlrath S, Stebbins B. The effects of a 6-week dynamic core stability plank exercise program compared to traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, oswestry disability index (ODI), and pelvic floor disability index scores (PFDI). Phys Ther Rehabil. 2016;3:3. http://dx.doi.org/10.7243/2055-2386-3-3

Benjamin DR, van de Water ATM, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy. 2014;100(1):1-8. https://doi.org/10.1016/j.physio.2013.08.005

Candido G, Lo T, Janssen PA. Risk factors for diastasis of the recti abdominis. J Assoc Chart Physiother Womens Health. 2005;97:49-54.

van de Water ATM, Benjamin DR. Measurement methods to assess diastasis of the rectus abdominis muscle (DRAM): A systematic review of their measurement properties and meta-analytic reliability generalisation. Man Ther. 2016;21:41-53. https://doi.org/10.1016/j.math.2015.09.013