Shohaimi, Suhaila
(2020)
The effect of abdominal exercise on diastasis recti abdominal (dra) among postpartum primigravida mother in Kuala Lumpur.
Masters thesis, Universiti Sains Malaysia.
Abstract
Abdominal exercise for diastasis recti abdominal (DRA) during postpartum has
yet to be explored in research. Despite general exercise programs in current
rehabilitation, strength and conditioning programs, few studies have examined the
implementation of gradual and progressions abdominal training, and the benefits
therein. The objective of this study was to investigate the effects of a progressive
abdominal exercise known as Split Tummy Exercise Program (STEP) on the DRA
size, pelvic floor muscle (PFM) strength, endurance and perceived urinary distress
symptoms and determine the correlation between these variables. STEP module was
developed based on literature review and validated by the experts. A randomized
control trial study design was carried out at Obstetric and Gynaecology clinic,
University Kebangsaan Malaysia Medical Centre (UKMMC) Kuala Lumpur and 41
pregnant women were selected. Later the participants were randomly assigned to the
intervention (21 subjects) and control group (20 subjects). The participants were
selected among primigravida diagnosed with DRA at 34-week gestations onward if the
gap between the abdominal muscle is more than two-finger width measured with finger
palpation at the umbilicus. Those with multiple pregnancies, previous abdominal and
urogenital surgery, lower caesarian section delivery, and disease that could interfere
with PFM strength such as Ehlan Danlos Syndrome were excluded. The intervention
group received STEP module consist of three phases of nine abdominal exercises. The
progression from phase one to phase two was administered every three weeks and
completed phase three at eight weeks postpartum. DRA size ( using 2D ultrasound)
and urinary functions (using Urogenital Distress Inventory questionnaire - UDI-6 and
Incontinence Impact questionnaire - IIQ-7) were assessed at baseline and 8-weeks
postpartum, whereas the PFM strength and endurance (using perineometer) was
evaluated at 8-weeks postpartum for both groups. Out of 41 participants, 87.8% were
Malays with the mean age of 28 years old (SD=0.56), and most of them (78%) were
working. After 8 weeks, both groups had a reduction of DRA size, but result between
the group was not significant whereas within-group analysis, DRA size was reduced
up to 27% (mean difference: 6.2; 95% CI: 3.7, 8.7) as compared to 8.2% (mean
difference:1.66; 95% CI: -1.3, 4.6) in the control group with significant intervention
effect at p<0.001. There is a significant difference in PFM strength with a mean
difference of 5.89 mmHg (95% CI: 2.10, 9.68; p=0.003) and PFM endurance with the
mean difference of 1.11 second (95% CI: 0.01, 2.22; p=0.049) between groups. On
the other hand, for urinary function, there is no significant difference in urinary distress
symptoms between-group however, within-group analysis, both groups show
significant different (p<0.001). In conclusion, the abdominal exercise using eight
weeks STEP module effectively reduce the DRA size and could be implemented for
mothers with DRA. The strength and endurance of PFM are higher in the STEP group
at 8 weeks postpartum and no significant difference in perceived urinary incontinence
symptom between the group. Finally, no relationship was found between DRA size
and PFM function and perceived urinary distress symptoms. Further research is
warranted to ascertain the efficacy of abdominal exercise among a larger population.
| Item Type: |
Thesis
(Masters)
|
| Uncontrolled Keywords: |
abdominal exercise |
| Subjects: |
R Medicine |
| Divisions: |
UNSPECIFIED |
| Depositing User: |
Mr Abdul Hadi Mohammad
|
| Date Deposited: |
28 Jan 2021 05:37 |
| Last Modified: |
28 Jan 2021 05:37 |
| URI: |
http://eprints.usm.my/id/eprint/48211 |
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