Rehabilitation programme including EMG-biofeedback- assisted pelvic floor muscle training for rectus diastasis after childbirth: a randomised controlled trial

Abstract

Objective: To evaluate the effect of a comprehensive rehabilitation programme on closure of the rectus diastasis (RD) and quality of life in women after delivery.

Design: A randomised controlled trial with blinded assessment.

Setting: A tertiary hospital and participants' homes in Foshan, China.

Subjects: Sixty-six women with RD 2-6 months after delivery were recruited into this study (study group n = 33, control group n = 33). The mean age of participants was 29.9 [standard deviation (SD) 4.3] years.

Interventions: Each participant performed abdominal exercises. Patients in the study group received electromyographic-biofeedback-assisted pelvic floor muscle training (BAPFMT) in combination with neuromuscular electrical stimulation (NMES) of the rectus abdominis, and patients in the control group underwent NMES of the rectus abdominis alone.

Main outcomes: The main study outcomes were inter-recti distance (IRD) and change in Short-Form Health Survey-36 (SF-36) scores 6 weeks after the intervention.

Results: A significant decrease in IRD was observed in the study group at 6 weeks [study group 1.6 (SD 0.3) cm vs control group 2.0 (SD 0.3); mean difference - 0.4, 95% confidence interval (CI) - 0.59 to - 0.26]. Similarly, the physical component summary, an integral component of SF-36, showed a significant improvement in the study group compared with the control group at 6 weeks [study group 45.5 (SD 1.2) vs control group 41.2 (SD 2.6); mean difference 4.3, 95% CI 3.72-4.50].

Conclusion: A postpartum programme including BAPFMT for women with RD is feasible and improves the physical domain of quality of life.

Clinical trial registration: ClinicalTrials.fimmu, No: RCT 02561078. CONTRIBUTION OF THE PAPER.

Keywords: Electromyographic biofeedback; Pelvic floor muscle training; Postpartum women; Rectus diastasis.