Related Experiment Video
Updated: Jan 16, 2026
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Transversus abdominis and rectus abdominis activation exercises do not alter inter-recti distance in pregnant women:
Alana Leandro Cabral1, Angélica Lemos Debs Diniz2, Elder Henrique de Oliveira3
1Postgraduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia, Brazil.
Questions:
What are the effects of transversus abdominis (TrA) or rectus abdominis (RA) activation exercises, compared with general exercise without specific abdominal activation, on the inter-recti distance (IRD) in pregnant women? How do TrA and RA activation exercises compare with general exercise for their effects on pelvic floor dysfunction?
Design:
Three-arm randomised controlled trial with assessor blinding, concealed allocation and intention-to-treat analysis.
Participants:
Sixty-three primigravida pregnant women at 18 to 21 gestational weeks.
Intervention:
The control group performed general exercises without abdominal focus. In addition to the control group intervention, the drawing-in group added TrA activation exercises, and the abdominal crunch group added RA-targeted exercises. All groups completed 24 sessions over 12 weeks.
Outcome Measures:
The primary outcome was change in IRD (mm), measured 2 cm above and below the umbilicus, at rest and during active trunk flexion. The secondary outcome was the Pelvic Floor Bother Questionnaire, which scores the severity of symptoms of pelvic floor dysfunction.
Results:
All groups showed a similar increase in IRD after intervention. No substantial differences were observed between either targeted exercise group and the control group. At 2 cm above the umbilicus, general exercises had a similar effect to the in-drawing TrA exercises (between-group difference 6 mm, 95% CI -3 to 15) or the RA exercises (4 mm, 95% CI -5 to 12) at rest. Similar or smaller between-group differences occurred below the umbilicus and during trunk flexion. Similar or smaller between-group differences occurred between the drawing-in and abdominal crunch groups. No substantial between-group differences were found in pelvic floor dysfunction symptoms.
Conclusion:
A 12-week abdominal exercise program focusing on TrA or RA activation did not substantially change IRD or pelvic floor dysfunction symptoms compared with general exercise; this suggests that pregnant women do not need to avoid targeted TrA or RA exercises.
Registration:
RBR-4v2r4bg.
Related Concept Videos
01:21Muscles of the Abdomen
Anterolateral Region
The anterolateral region comprises five paired muscles classified into the lateral and...
01:26Muscles of the Pelvic Floor and Perineum
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:23Assessment of the Abdomen III: Palpation
01:19Abdominal Regions and Quadrants
The simpler quadrants approach, which is more commonly used in medicine, subdivides the cavity with one horizontal and one vertical line that intersects at the patient's umbilicus (navel). The four...