Efeito de um programa de treinamento dos músculos reto abdominais na distância inter retos de gestantes

Abstract

Pregnancy leads to anatomical and systemic changes in the woman's body, and, due to fetal and uterine growth, there is a separation of the portions of the rectus abdominis muscle, causing an increase in the inter-rectus distance (IRD). Excessive distancing leads to a condition called Diastasis of the Rectus Abdominals (DRA), a dysfunction of the muscle bellies that can generate imbalance of forces and functional changes.In the literature, there are hypotheses that prenatal physical training can help prevent DRA, indicating that there is a probable preservation of muscle tone, strength and control of the abdominal portion. However, no studies were found to confirm or refute this hypothesis. Therefore, the present study aims to evaluate the effects of a training program for the rectus abdominis muscles on the IRD of pregnant women.This study included 5 pregnant women (29.6 ± 4.5 years), primigravidae and singleton pregnancies; with gestational age between 18 and 21 weeks. Initially, the participants were submitted to a standard questionnaire, and then the IRD evaluation, via ultrasonography, measured in two points of the linea alba (supraumbilical and infraumbilical), in two positions: at rest and in trunk flexion. After that, the intervention was started for 12 weeks, twice a week. In all sessions, two exercises of moderate intensity focused on activating the rectus abdominis muscle (abdominal crunch and abdominal crunch with flexible elastic band) were performed, followed by global exercises, altered according to the evolution of the pregnancy. After 12 weeks, the participants were reassessed and the results obtained indicated that at rest there was a significant difference when comparing the values before and after the intervention, with higher values after the intervention (p=0.0079 and p=0.0148, respectively). In trunk flexion, no significant differences were observed before and after the intervention (p=0.0604), in the supraumbilical region, however, in the infraumbilical region, a significant difference was observed (p=0.0464), with higher values after the intervention. It was concluded that abdominal training prevented a significant increase in IRD in the supraumbilical region in trunk flexion, but did not prevent the increase in IRD in the other measures taken.