産後の腹直筋離開に対する体幹ウェアラブル神経筋電気刺激装置の効果：前向き無作為化比較試験

Diastasis of rectus abdominis (DRA) is a common pathological condition in postpartum rehabilitation, but with limited treatment strategies. This study aimed to explore the effect of using a trunk-wearable neuromuscular electrical stimulation (NMES) device on postpartum women with moderate and severe DRA. A total of 84 postpartum women with an inter-rectus distance (IRD) of ≥3 cm were randomly assigned to two equal groups. The treatment group received a trunk-wearable NMES device and exercise therapy, whereas the control group received exercise only. We measured IRD and calculated treatment response proportion, improvement of trunk muscle strength, and low-back pain in both groups. Additionally, we evaluated quality of life (QoL) using the SF-36 questionnaire and Hernia-related Quality of Life Survey (HerQLes). Statistical analysis was performed using SAS 9.4. After 8-week treatment, the IRD of the umbilical (M3) sector showed a greater reduction in the treatment group (-10.6 [-17.9 to -3.3]%, p < 0.05). Patients in the treatment group had higher treatment response proportions (p = 0.0031 and p = 0.0010, W2 and W3, respectively). Additionally, the treatment group had higher Janda assessment scores and greater reduction in low-back pain (both p < 0.0001). QoL evaluation indicated greater improvements in the SF-36 questionnaire (pain and role-emotional scales,p < 0.05) and HerQLes (p < 0.0001) in the treatment group. The application of a trunk-wearable NMES device on DRA patients, accompanied by exercise therapy, significantly reduced IRD and increased the treatment response proportion. Moreover, we observed positive improvements in trunk muscle strength, low-back pain, and QoL.