Immediate Effect of Four Exercises on Linea Alba Thickness, Distortion and Inter-Recti Distance in Parous Women

Area of Science:

• Pelvic floor rehabilitation
• Abdominal wall biomechanics
• Postpartum recovery

Background:

• Diastasis recti abdominis (DRA) is common in parous women.
• Understanding the biomechanical effects of abdominal exercises is crucial for postpartum recovery.
• Linea alba (LA) integrity is important for abdominal wall function.

Purpose of the Study:

• To assess the impact of four abdominal exercises on inter-recti distance (IRD) and linea alba (LA) distortion and thickness in parous women.
• To compare the effects of crunch, abdominal drawing-in maneuver (ADIM), pelvic floor muscle contraction, and de Gasquet basic exercise.
• To evaluate transversus abdominis (TrA) activation during these exercises.

Main Methods:

• Cross-sectional ultrasound assessment of 54 parous women during four distinct abdominal exercises.
• Primary outcome: inter-recti distance (IRD) at supra- and infraumbilical levels.
• Secondary outcomes: LA distortion and thickness, and TrA activation, analyzed using mixed-effects models.

Main Results:

• The crunch exercise demonstrated the greatest supraumbilical IRD decrease, but with significantly increased LA distortion and thickness compared to other exercises.
• ADIM, pelvic floor muscle contraction, and de Gasquet exercise showed smaller IRD changes and reduced or maintained LA distortion.
• TrA activation varied by exercise: greater thickening correlated with IRD decrease during ADIM, while lower activation correlated with IRD decrease during crunch.

Conclusions:

• While the crunch exercise offers a rapid supraumbilical IRD reduction, it poses a higher risk of LA distortion.
• ADIM, pelvic floor muscle contraction, and de Gasquet exercise appear to be safer alternatives with lower LA distortion.
• Exercise-specific TrA activation patterns influence rectus abdominis deformation, highlighting the need for tailored postpartum exercise prescription.