腹直筋離開修復後の体幹筋力回復：腹部形成術後の腹筋機能に関する前向き比較試験

Diastasis recti abdominis (DRA) is characterized by a pathological widening of the linea alba, leading to impaired core stability, reduced trunk function, and compromised quality of life. Despite the widespread use of abdominoplasty with rectus sheath plication for the correction of diastasis, objective functional outcomes remain underreported.

This study aims to evaluate the impact of abdominoplasty with rectus sheath plication on abdominal muscle strength, anatomical restoration and patient-reported outcomes in patients with DRA.

A prospective single-center study was conducted on 50 female patients (mean age 42.6 ± 7.8 years) with moderate-to-severe DRA (inter-rectus distance [IRD] ≥ 2.0 cm). Objective core strength was assessed using isokinetic dynamometry (Biodex System 4), and anatomical restoration was evaluated via high-resolution ultrasonography. Patient-reported functional capacity was measured with a validated outcome instrument. Assessments were performed at baseline, 1 month, and 6 months postoperatively.

At 6 months, mean core strength increased from 182 ± 25 N to 256 ± 28 N. IRD significantly decreased from 3.4 ± 0.6 cm to 0.8 ± 0.3 cm (p < 0.001). Patient-reported outcome measure (PROM) scores improved from 56.2 ± 8.4 to 82.7 ± 6.9 (p < 0.001). Therer was an ultrasound-confirmed complete midline continuity in all patients, with no recurrences >1 cm. Complications were minimal (seroma 6%, no major events).

Abdominoplasty with rectus sheath plication improves core strength, restores linea alba integrity, and enhances the quality of life. Beyond aesthetic outcomes, it constitutes a biomechanically restorative procedure with reconstructive value.

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