Effects of Tupler's Technique on Postpartum Diastasis Recti and Strength Recovery of Abdominal Muscles

Riphah International University

Status: Completed

Conditions: Diastasis Recti

Treatments: Other: conventional therapy; Other: Tupler technique

Study type: Interventional

Funder types: Other

Identifiers

NCT05111483

REC/RCR&AHS/21/0509

Details and patient eligibility

About

Diastasis rectus is the separation of the muscles along the midline of the abdomen, typically as seen in women after pregnancy. Separation is mostly larger than 2cm width at above, below or level of umbilicus. With this muscular pathology women do not feel any pain symptom just perceiving symptoms of physical discomfort, abdomen muscle weakness and its bulging. Excess weight of mother or baby and multiple birth pregnancy is the common risk factor for the DRA. Various tools will be used for the diagnosis of DRA such as vernier caliper by using centimeter ruler, diagnostic ultrasonography that give the exact measurement, pressure biofeedback unit which is used to assess the strength of weak muscles, and patient specific functional scale that used to determine the functional limitation and its improvement.

To treat the DRA conservatively, Tupler's technique and conventional physical therapy will be directed. Electrical muscular stimulations will also be given as a baseline before applying both treatments. In Tupler's technique, diastasis rehab splint and Tupler's exercises will be used whereas in conservative physical therapy, scarf tie around abdomen while performing exercises, Respiratory rehabilitation manoeuvre and abdominal muscle exercises will be used. The aim of the study is to find the the effects of Tupler's technique and conventional physical therapy treatment for abdominal muscle strength regaining and in reducing the diastasis recti among females with diastasis recti after their postpartum period. It is a Randomized clinical trial and convenient random sampling is to be used with an inclusion criterion of patients having age between 20-40 years, Both primiparous and multiparous women and Diastasis recti more than 2.5cm within 6 weeks or more postpartum. Patients will be randomly allocated into two groups, Group A will receive Tupler's technique and Group B will receive conventional physical therapy intervention. Total duration of study will be six months. Assessment will be done before and after the treatment. Pressure biofeedback unit, vernier caliper, ultrasound and patient specific functional scale are to be used to measure the outcomes. Data will be assessed by using parametric/non parametric test after completion of study.

Enrollment: 34 patients

Sex: Female

Ages: 20 to 40 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged between 20-40 years
• Both Primiparous and Multiparous women
• Diastasis recti more than 2.5cm within 6 weeks or more postpartum

Exclusion criteria

• Neurological signs, specific spinal pathology (e.g. disc lesions, malignancy, or inflammatory disease) or any other major medical pathology.
• Any complication during pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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34 participants in 2 patient groups

Tupler's technique

Experimental group

Description:

The subjects with DRA will receive Tupler's technique treatment plan for 18 weeks in which four steps will be followed. 1. Repositioning with diastasis rehab splint : 2. Protect the connective tissue 3. Tupler's technique exercises (elevators, contractions, standing pelvic tilt, head lifts, leg slides, low back stretch) with 10 repetitions for each exercise. 4. Diastasis safe exercises program to maintain the gains

Treatment:

Other: Tupler technique

conventional therapy

Experimental group

Description:

The subjects with DRA will receive conventional physical therapy treatment for 16 weeks in which researcher will follow these steps: 1. Tie a scarf around abdomen while performing exercises 2. Exercise program for diastasis recti abdominal muscles; sit ups, reverse sit ups, reverse trunk twist and U-seat exercises. (10 repetitions for each exercise) 3. Respiratory rehabilitation manoeuvre

Treatment:

Other: conventional therapy