Effect of Inspiratory Plus Expiratory Neuromuscular Electrical Stimulation on Diastasis Recti Abdominis in Postpartum.

BACKGROUND

The treatment of postpartum diastasis recti abdominis requires a comprehensive approach that considers the integrated function of the core muscle group, rather than focusing solely on the isolated stimulation of the rectus abdominis.

PURPOSE: To investigate the effects of inspiratory plus expiratory neuromuscular electrical stimulation in patients with postpartum rectus abdominis separation.

METHODS

Sixty patients diagnosed with postpartum Diastasis Recti Abdominis (DRA) were randomly assigned, using a random number table, to either a control group (n = 30) or an intervention group (n = 30). Both groups participated in a standardized postpartum rehabilitation program for 4 weeks, consisting of daily 20-min treatment sessions, 5 days per week. The control group received electrical stimulation targeting the rectus abdominis muscles, whereas the intervention group underwent inspiratory plus expiratory neuromuscular electrical stimulation. To assess the outcomes, a blinded assessor utilized high-frequency ultrasound to measure the separation distance of the rectus abdominis, the thickness of the transversus abdominis, and the thickness of the diaphragm both pre- and post-intervention. Additionally, the diaphragm thickening ratio was calculated.

RESULTS

At baseline, no significant differences were observed between the two groups. However, following the 4-week intervention, both groups demonstrated significant reductions in rectus abdominis separation (p < 0.05). Notably, the intervention group exhibited significantly greater improvements in rectus abdominis separation at the supra-umbilical and umbilical regions compared with the control group (p = 0.040 and p < 0.001, respectively). Furthermore, the intervention group showed significant increases in diaphragm thickening ratio and transversus abdominis thickness (p = 0.025 and p < 0.001, respectively) relative to the control group.

CONCLUSION

The addition of inspiratory plus expiratory neuromuscular electrical stimulation to conventional postpartum rehabilitation significantly improves outcomes in patients with postpartum DRA. Overall, these findings provide evidence for a novel therapeutic approach that targets both abdominal muscle function and respiratory mechanics, offering a promising direction for the management of DRA in postpartum women.