Effectiveness of diastasis recti abdominis rehabilitation exercises on postpartum low back pain and inter-recti distance in affected women: A randomized controlled trial

This study aimed to investigate the effects of a comprehensive rehabilitation protocol for treating diastasis recti and improving postpartum low back pain, and to investigate the relationship of these changes with brain and muscle activity patterns in women with postpartum low back pain.

Quasi-experimental, randomized clinical trial with two parallel arms and double-blinded.

Participants will be recruited from gynecology and obstetrics clinics, health centers, and social media platforms within Hamadan city. Initial evaluations will take place at the Sports Rehabilitation Laboratory of Bu-Ali Sina University. Before enrollment, all participants will receive clear and comprehensive information regarding the study’s procedures, duration, objectives, potential benefits, and possible risks.

Inclusion: Women with postpartum LBP, aged 20-45 years, with multiparity, vaginal delivery, and diastasis recti greater than 2 cm above, below, and umbilicus. Exclusion: cardiac and respiratory diseases, acute LBP, rheumatic spinal diseases, CNS and PNS diseases, abdominal hernia, lumbar surgery, gestational diabetes, and sports activities.

Exercise Group: Participants will undergo a structured diastasis recti rehabilitation program, incorporating progressive core trunk exercises, from beginner to advanced levels, and targeted release techniques for the erector spinae muscles. Control Group: Participants will maintain their usual daily routines throughout the study period.

Low back pain and disability, Inter-rectus distance, Core muscle thickness, Thoracolumbar fascia flexibility, lumbopelvic proprioception dysfunction, Lumbopelvic motor control, EMG-based core muscle activation patterns, EEG-based brain activity patterns in proprioceptive and pain receptors

In this study, subjects will be randomized based on the Random Number Generator software and then assigned to dual groups based on allocation concealment using the SNOSE method. Participants will be randomly assigned to one of the rehabilitation exercise groups (n=20) or the control group (n=20).

The assessors and study participants are blinded to the allocation and randomization of groups. Participants will be fully informed of the study’s purpose and inclusion rationale, while remaining blinded to group allocation to minimize bias and ensure methodological integrity.

Only data related to demographic information and outcomes will be shared.

After publishing the article/articles extracted from the study

The data can be displayed and shared upon reasonable request by the Iranian Clinical Trial Registry Center, journals, and individuals/academic researchers who are conducting research and scientific activities in this field.

Data analysis and use of documentation can only be done on the condition that their results are stated in systematic review articles conducted by researchers and academic authors. Conditions for registering the submission of data and documentation include: 1. Sending an email (preferably with valid academic addresses) to one of the study researchers. 2. A brief and logical explanation regarding how the data or documentation will be used. 3. Ensuring the registration of the protocol of systematic review studies that have given access to the data or documentation.

By requesting from the study researcher, Nahid Bigdeli, by email n.bigdeli@phe.basu.ac.ir

The applicant can request details from the researchers using an email message within 7 to 10 days.