Efeito dos exercícios hipopressivos sobre a função dos músculos abdominais em puérperas com diástase dos reto abdominais: ensaio clínico controlado randomizado

Abstract

Background: Diastasis rectus abdominis (DRA) is characterized by an increase in the distance between the rectus abdominis along the linea alba. This is a physiological condition in response to fetal growth and hormonal action during pregnancy that makes the ligaments more malleable. Several conservative treatments are used by physiotherapists to resolve permanent cases of DRA, including the hypopressive method proposed by Caufriez. However, there is no consensus on the effects of the hypopressive method in women with DRA. Objectives: To analyze the effect of hypopressive exercises on the function of the abdominal muscles in puerperal women with DRA. Methods: This is a randomized clinical trial in which women with a postpartum period of 45 days to six months and diagnosed with diastasis were included, considered from 2 cm away from a point along the linea alba. evaluated by ultrasonography. 44 participants were included, randomly allocated into two groups composed of 22 women in which the intervention group received hypopressive training for 12 weeks and the control group did not perform any training for a similar time. The trainings were offered in groups, by a qualified instructor, twice a week for 30 minutes. The evaluation of the abdominal muscles function was performed before and after 12 weeks in both groups through the plank test (The Bridge Test), in its ventral, left lateral and right lateral versions. The time held in position was measured in seconds. Data were analyzed statistically with intention-to-treat analysis using the ANOVA test for repeated measures. Results: The results showed that there was an increase in the time of sustaining the plank test only in the intervention group, with a statistically significant difference for the frontal, right and left lateral tests when comparing the control and intervention groups after 12 weeks (p<0, 05). Conclusion: It is concluded that hypopressive training can improve the abdominal muscle function of puerperal women with DRA.