Hypopressive exercises for diastasis recti and pelvic floor symptoms in postpartum women: A randomized trial

Diastasis recti abdominis (DRA) is a common postpartum condition that can persist for months, impair abdominal function, and negatively affect quality of life. Despite its prevalence, there is no gold standard treatment. Hypopressive exercises have been proposed as a therapeutic option, but evidence from randomized controlled trials is limited.

To evaluate the effects of a 12-week hypopressive training program on inter-recti distance (IRD) in postpartum women and its impact on body perception, abdominal function, and pelvic floor symptoms.

Forty-four primiparous or multiparous women, 45 days to 6 months postpartum, with DRA ≥20 mm at any point on the linea alba, were randomized into two groups. The hypopressive group (HG) underwent a standardized 12-week program, twice weekly, 30 min per session, under professional supervision. The control group (CG) received no intervention. The primary outcome was the change in IRD measured by ultrasonography. Secondary outcomes included abdominal muscle function assessed by bridge tests, body image perception, and pelvic floor complaints using the Pelvic Floor Bother Questionnaire.

No significant difference was observed between groups in the change in IRD. There was a significant difference between groups in abdominal muscle function in the prone bridge [34 s (95% CI 13, 55)], right side [12 s (95% CI 3, 21)], and left side tests [16 s (95% CI 7, 25)], body appreciation [9 (95% CI 5, 13)] and pelvic floor dysfunctions complaints [-4 (95% CI -6, -2)].

Hypopressive training did not reduce DRA, but it improved abdominal muscle function, body image perception, and pelvic floor dysfunction complaints when compared to the control group.