Physiotherapy with kinesiotherapy and physical agents to reduce postpartum diastasis recti: a randomised trial

BACKGROUND: Diastasis recti abdominis (DRA) is characterised by a separation of the rectus abdominis muscles, which is common in the postpartum period. This randomised controlled trial investigated the effects of a physiotherapy protocol combining abdominal exercises and physical agents-namely electromagnetic shock waves, transfer of energy capacitive and resistive (TECAR) therapy, and neuromuscular electrical stimulation-on reducing the inter-rectus distance in women with DRA six months after childbirth. METHODS: Sixty women diagnosed with DRA were randomised into three groups: kinesiotherapy (Group A); electromagnetic shock waves, TECAR therapy, and neuromuscular electrostimulation (Group B); and a combination of both (Group C). The inter-rectus distance (IRD) of participants was assessed before and after treatment, with re-evaluation conducted sixty days after the initial assessment, using ultrasound and abdominal perimeter measurements. RESULTS: group C showed a 0.80 cm reduction in supraumbilical IRD when compared with Group B. In the infraumbilical region, Group C had a 0.74 cm reduction compared to Group A and 0.85 cm compared to Group B. Regarding abdominal perimeter, Groups B and C showed greater reductions in the infraumbilical circumference than Group A, with mean differences of approximately 10 cm. No significant differences were observed in the supraumbilical and umbilical regions. CONCLUSIONS: the combination of kinesiotherapy and physical agents is more effective in reducing inter-rectus distance and abdominal circumference than either approach alone in postpartum women with diastasis recti abdominis.