Volume 18, Issue 2 (May 2020)                   Nursing and Midwifery Journal 2020, 18(2): 84-94 | Back to browse issues page

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yalfani A L, bigdeli N, Anvari R, gandomi F. COMPARISON OF STATIC, DYNAMIC BALANCE AND CURVATURE OF THE SPINE IN WOMEN WITH AND WITHOUT DIASTASIS RECTI ABDOMINAL IN THE POSTPARTUM PERIOD. Nursing and Midwifery Journal 2020; 18 (2) :84-94
URL: http://unmf.umsu.ac.ir/article-1-4055-en.html
COMPARISON OF STATIC, DYNAMIC BALANCE AND CURVATURE OF THE SPINE IN WOMEN WITH AND WITHOUT DIASTASIS RECTI ABDOMINAL IN THE POSTPARTUM PERIOD
A. li Yalfani * 1, Nahid Bigdeli2 , Roghayeh Anvari3 , Farzaneh Gandomi4
1- Associate Professor, Sport rehabilitation Ph. D, Department of Sport Injuries and Corrective Exercises, Bu Ali Sina University, Hamedan, Iran (Corresponding Author) , ali_yalfani@yahoo.com
2- Master of Sport Injuries and Corrective Exercises, Department of Sport Injuries and Corrective Exercises, Bu Ali Sina University, Hamedan, Iran
3- Assistant Professor, Department of Gynecology, School of medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4- Assistant professor, Sport Injuries and Corrective Exercises Ph. D, Department of Sport Injuries and Corrective Exercises, Razi University, Kermanshah, Iran
Abstract:   (3086 Views)
Background & Aims: Increasing in the inter-recti abdominal muscle during pregnancy and postpartum, called diastasis recti abdominal.  Many musculoskeletal disorders occur in women with diastasis recti After pregnancy in the lumbopelvic region. This research article aims to compare the static, dynamic balance and curvature of the spine in women with and without diastasis recti abdominal in the postpartum period. Materials & Methods: This study is a retrospective study of the type of case_control. Forty women participated in the study, 2 to 5 months after childbirth, and were divided into two groups, healthy(n=20) with a mean age of 26.4± 4.88 years and diastasis recti(n=20) with a mean age of 29.5 ± 5.88 years. To assessment the two groups in this study, a flexible ruler was used to assess the curvature of the spine and to measure static and dynamic balance using the Biodex balance system. The information was analyzed using SPSS software version 24 and an independent t-test. Results: The results of this study showed that between the two groups, the lumbar lordosis angle was significant (P≤0.05) and the kyphosis angle was non-significant (P≥0.05). Also, the results of static balance in the overall, anterior-posterior and lateral-medial stability, showed a significant difference between the two groups (p 050.05), but in dynamic balance except in anterior-posterior stability(P≤0.05), not observed a significant difference(P≥0.05). Conclusion: This study showed that lumbar hyperlordosis and postural instability are associated with diastasis recti Abdominal, and women with this disorder have little improvement after childbirth without treatment modalities, because after childbirth due to shrinking uterine volume, Abdominal muscles become weakness and sag, and there is a lack of muscle support in this area, which can increase the postural instability of patient women compared to healthy women and slow the recovery process of hyperlordosis.
Keywords: Diastasis Recti, Pregnancy, Static Balance, Dynamic Balance, Hyperlordosis, Kyphosis
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Type of Study: Research | Subject: مامایی
References
1. Pascoal AG, Dionisio S, Cordeiro F, Mota P. Inter-rectus distance in postpartum women can be reduced by isometric contraction of the abdominal muscles: a preliminary case-control study. Physiotherapy. 2014 Dec 1;100(4):344-8. [DOI:10.1016/j.physio.2013.11.006] [PMID]
2. El-Mekawy HS, Eldeeb AM, El-Lythy MA, El-Begawy AF. Effect of abdominal exercises versus abdominal supporting belt on post-partum abdominal efficiency and rectus separation. In: Proceedings of World Academy of Science, Engineering and Technology. World Academy of Science, Engineering and Technology (WASET); 2013. p. 742. [Google Scholar]
3. Blotta RM, Costa SD, Trindade EN, Meurer L, Maciel-Trindade MR. Collagen I and III in women with diastasis recti. Clinics 2018;73. [DOI:10.6061/clinics/2018/e319] [PMID] [PMCID]
4. Axer H, Keyserlingk DG, Prescher A. Collagen fibers in linea alba and rectus sheaths: I. General scheme and morphological aspects. J Surg Res 2001;96(1):127-34. [DOI:10.1006/jsre.2000.6070] [PMID]
5. Boissonnault JS, Blaschak MJ. Incidence of diastasis recti abdominis during the childbearing year. Physical therapy. 1988;68(7):1082-6. [DOI:10.1093/ptj/68.7.1082] [PMID]
6. Noble E. Essential exercises for the childbearing year: a guide to health and comfort before and after your baby is born. Houghton Mifflin; 1988. [URL]
7. Bursch SG. Interrater reliability of diastasis recti abdominis measurement. Physical therapy 1987 Jul 1;67(7):1077-9. [DOI:10.1093/ptj/67.7.1077] [PMID]
8. Lee DG, Lee LJ, McLaughlin L. Stability, continence and breathing: the role of fascia following pregnancy and delivery. Journal of bodywork and movement therapies. 2008 ;12(4):333-48. [DOI:10.1016/j.jbmt.2008.05.003] [PMID]
9. Fast AV, Weiss L, Ducommun EJ, Medina EV, Butler JG. Low-back pain in pregnancy. Abdominal muscles, sit-up performance, and back pain. Spine 1990 Jan;15(1):28-30. [DOI:10.1097/00007632-199001000-00008] [PMID]
10. Rett MT, Braga MD, Bernardes NO, Andrade SC. Prevalence of diastasis of the rectus abdominis muscles immediately postpartum: comparison between primiparae and multiparae. Braz J Phys Ther 2009 Aug;13(4):275-80. [Google Scholar]
11. Candido G, Lo T, Janssen PA. Risk factors for diastasis of the recti abdominis. Jorurnal- Association of Chartered Physiotherapists in Womens Health 2005; 97:49. [Google Scholar]
12. Benjamin DR, Frawley HC, Shields N, van de Water AT, Taylor NF. Relationship between diastasis of the rectus abdominis muscle (DRAM) and musculoskeletal dysfunctions, pain and quality of life: a systematic review. Physiotherapy 2019 Mar 1;105(1):24-34. [DOI:10.1016/j.physio.2018.07.002] [PMID]
13. James DK, Steer PJ, Weiner CP, Gonik B, Robson SC, editors. High-risk pregnancy: management options. Cambridge University Press; 2017. [DOI:10.1017/9781108664677]
14. Gutke A, Östgaard HC, Öberg B. Predicting persistent pregnancy-related low back pain. Spine. 2008;33(12): E386-93. [DOI:10.1097/BRS.0b013e31817331a4] [PMID]
15. Gutke A, Östgaard HC, Öberg B. Association between muscle function and low back pain in relation to pregnancy. Journal of rehabilitation medicine. 2008;40(4):304-11. [DOI:10.2340/16501977-0170] [PMID]
16. Padua L, Caliandro P, Aprille I, Pazzaglia C, Padua R, Calistri A, et al. Back pain in pregnancy: 1-year follow up of untreated cases. Eur Spine J 2005. 14(2): 151-4. [DOI:10.1007/s00586-004-0712-6] [PMID] [PMCID]
17. Stapleton DB, Mac Lennan AH, kristiansson P. The prevalence of recalled low back pain during andafter pregnancy: A south Australian population survey. Aust NZJ Obstet Gyneacol 2002. 42: 482-85. [DOI:10.1111/j.0004-8666.2002.00482.x] [PMID]
18. Oliveira LF, Vieira TM, Macedo AR, Simpson DM, Nadal J. Postural sway changes during pregnancy: a descriptive study using stabilometry. Eur J Obstet Gynecol Reprod Biol 2009; 147:25-8. [DOI:10.1016/j.ejogrb.2009.06.027] [PMID]
19. Gilleard WL, Crosbie J, Smith R. Static trunk posture in sitting and standing during pregnancy and early postpartum. Archives of physical medicine and rehabilitation. 2002;83(12):1739-44. [DOI:10.1053/apmr.2002.36069] [PMID]
20. Okanishi N, Kito N, Akiyama M, Yamamoto M. Spinal curvature and characteristics of postural change in pregnant women. Acta obstetricia et gynecologica Scandinavica 2012;91(7):856-61. [DOI:10.1111/j.1600-0412.2012.01400.x] [PMID]
21. Kisner C, Colby LA, Borstad J. Therapeutic exercise: foundations and techniques. Fa Davis; 2017 Oct 18. [Google Scholar]
22. Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil 2004 Mar;85(3 Suppl 1):S86-92. [DOI:10.1053/j.apmr.2003.12.005] [PMID]
23. Hodges PW. Core stability exercise in chronic low back pain. Orthopedic Clinics 2003 Apr 1;34(2):245-54. [DOI:10.1016/S0030-5898(03)00003-8] [PMID]
24. Ali Yalfani, Nahid Bigdeli, Mohammad Reza Ahmadi, Effectiveness of Abdominal Strengthening Exercises in the Treatment of Diastasis Recti in Postpartum Period. Sci J Rehabil Med 2019 8(4), 280-290. (Persian) [Google Scholar]
25. Mahalakshmi V, Sumathi G, Chitra TV, Ramamoorthy V. Effect of exercise on diastasis recti abdominis among the primiparous women: a quasi-experimental study. Int J Reprod Contracept Obstet Gynecol 2016;5(12):4441-6. [DOI:10.18203/2320-1770.ijrcog20164360]
26. Lo T. Diastasis of the recti abdominis in pregnancy: risk factors and treatment. Physiot Canada 1999:32-7. [URL]
27. Mota PG, Pascoal AG, Carita AI, Bø K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual Therapy 2015;20(1):200-5. [DOI:10.1016/j.math.2014.09.002] [PMID]
28. Mota P, Pascoal AG, Sancho F, Carita AI, Bo K. Reliability of the inter-rectus distance easured by palpation. Comparison of palpation and ultrasound measurements. Man Ther 2013; 18:294-8. [DOI:10.1016/j.math.2012.10.013] [PMID]
29. Candido G, Lo T, Janssen PA. Risk factors for diastasis of the recti abdominis. Jorurnal- Association of Chartered Physiotherapists in Womens Health 2005; 97:49. [URL]
30. Hinman MR. Factors affecting reliability of the Biodex Balance System: a summary of four studies. J Sport Rehabil 2000;9(3):240-52. [DOI:10.1123/jsr.9.3.240]
31. Pincivero DM. Learning effects and reliability of the Biodex Stability System. J Athl Train 1995;30: S35.
32. Schmitz R, Arnold B: Intertester and intratester reliability of a dynamic balance protocol using the biodex stability system. J Sport Rehabil 1998, 7: 95-101. [DOI:10.1123/jsr.7.2.95]
33. Gary B. Wilkerson & Ed Behan. The advantages of a dynamic stability system compared to a static force plate system for orthopedic and musculoskeletal rehabilitation. Biodex Balance SD. Clinical Resource Manual 1999. 3-12.
34. Takasaki H, Kikkawa K, Hall T. Measurement reliability for evaluating lumbopelvic curvature during active knee extension in sitting using a flexible ruler in individuals with clinically tight hamstring muscles: A secondary analysis. Open J Therapy Rehabil 2018 Feb 9;6(1):1-7. [DOI:10.4236/ojtr.2018.61001]
35. Butler EE, Colon I, Druzin ML, Rose J. Postural equilibrium during pregnancy: decreased stability with an increased reliance on visual cues. Am J Obstet Gynecol 2006; 195: 1104-8. [DOI:10.1016/j.ajog.2006.06.015] [PMID]
36. Kendall FP, McCreary EK, Kendall HO. Muscles, testing and function: testing and function. Lippincott Williams and Wilkins; 1983. [URL]
37. Whitcome KK, Shapiro LJ, Lieberman DE. Fetal load and the evolution of lumbar lordosis in bipedal hominins. Nature 2007;450(7172):1075-8. [DOI:10.1038/nature06342] [PMID]
38. Dumas GA, Reid JG, Wolfe LA, Griffin MP, McGrath MJ. Exercise, posture, and back pain during pregnancy: Part 1. Exercise and posture. Clinical Biomechanics 1995;10(2):98-103. [DOI:10.1016/0268-0033(95)92046-O] [PMID]
39. Opala-Berdzik A, Błaszczyk JW, Bacik B, Cieślińska-Świder J, Świder D, Sobota G, Markiewicz A. Static postural stability in women during and after pregnancy: a prospective longitudinal study. PloS one 2015;10(6). [DOI:10.1371/journal.pone.0124207] [PMID] [PMCID]
40. Norasteh A, Hajihosseini E, Emami S, Mahmoudi H. Assessing Thoracic and Lumbar Spinal Curvature Norm: A Systematic Review. Physical Treatments-Specific Physical Therapy Journal 2019 Oct 10;9(4):183-92. [DOI:10.32598/ptj.9.4.183]
41. Schröder G, Kundt G, Otte M, Wendig D, Schober HC. Impact of pregnancy on back pain and body posture in women. J Physical Therapy Sci 2016;28(4):1199-207. [DOI:10.1589/jpts.28.1199] [PMID] [PMCID]
42. Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil 2004; 85:86-92. [DOI:10.1053/j.apmr.2003.12.005] [PMID]
43. Bruyneel AV, Chavet P, Bollini G, Allard P, Mesure S. The influence of adolescent idiopathic scoliosis on the dynamic adaptive behavior. Neuroscience Letters 2008;447: 158-63. [DOI:10.1016/j.neulet.2008.10.007] [PMID]
44. Ali Yalfani, Nahid Bigdeli, F Gandomi, R Anvari, Survey the proprioception and control of the lumbopelvic in women with and without diastasis rectus and their relationship with postpartum pain and disability, Sci J Rehabil Med. In press 2020. [Google Scholar]
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