Does electrical stimulation assist in reduction of diastasis recti in females postpartum and improve perceived functional level? Title

Jennifer Wiley; Jeanne Welch

Does electrical stimulation assist in reduction of diastasis recti in females postpartum and improve perceived functional level? Title

Department of Physical Therapy

Research output: Contribution to conference › Presentation

Abstract

<div class="line" id="line-10"></div><div class="line" id="line-15"> <u> Background & Purpose </u></div><div class="line" id="line-18"></div><div class="line" id="line-20"> Diastasis rectus abdominis (DRA) may resultin loss of strength and function of the abdominal musculature. DRA commonlyaffects women during gestation and postpartum possibly leading to a decrease infunctional activities. Natural healing of DRA may occur within 8 weekspost-partum, but resolution may not occur in up to 30% of cases. Conservativemanagement of DRA includes patient education, physical therapy, and exercise. Thereare few studies which have investigated the use of Neuromuscular ElectricalStimulation (NMES). The purpose of this study was to investigate potentialchange in inter-rectus distance, trunk muscle synergies and timing during sitto stand transfers, and patient self-reported function following use of NMES onabdominal musculature.</div><div class="line" id="line-23"></div><div class="line" id="line-25"> <u> Case Description </u></div><div class="line" id="line-28"></div><div class="line" id="line-30"> A 7-month postpartum female gravida one,para one participated in this study. Outcome measures included: finger widthmeasurement, rehabilitative ultrasound imaging (RUSI), Patient SpecificFunctional Scale (PSFS), and surface electromyography (sEMG). All outcomemeasures were collected at initiation, 3 weeks follow up and 6 weeks.  Subject was provided a Slendertone FLEX™ NMESbelt to be worn for a 30 minute treatment 5 days/week for 6 weeks. Weeklycommunication with the subject was completed to enhance compliance with study protocol.</div><div class="line" id="line-35"></div><div class="line" id="line-37">  </div><div class="line" id="line-39"></div><div class="line" id="line-41"> Finger width measurement and RUSI wereused to measure IRD. PSFS was utilized to quantify the participant’sself-assessed activity limitations and measure functional outcomes.  sEMG captured trunk, abdominal, and hipmuscle activation during sit-to-stand transfers.</div><div class="line" id="line-46"></div><div class="line" id="line-48"> <u> Outcomes </u></div><div class="line" id="line-51"></div><div class="line" id="line-53"> Finger width measurement and RUSI wereused to measure IRD. PSFS was utilized to quantify the participant’sself-assessed activity limitations and measure functional outcomes.  sEMG captured trunk, abdominal, and hipmuscle activation during sit-to-stand transfers.</div><div class="line" id="line-58"></div><div class="line" id="line-60"> Subject decreased IRD as measured viafinger-width from 2.25 to 1.25 finger-widths relaxed and 2 to 1 finger-widthscontracted. RUSI demonstrated decreases in IRD at every measured interval inboth contracted and relaxed positions. Greatest decrease in RUSI measurement ofIRD was noted at 2cm superior to the umbilicus with a 69% reduction of thesubject’s IRD from initial measurement. The subject reported an average changeof PSFS score of 2.67 points surpassing the MCID. The subject reportedincreased functional improvement in lifting and decreases in incidence ofstress incontinence. Principle Component Analysis (PCA) was applied to the sEMGdata to assess coordination of muscle recruitment. The magnitude of principlecomponent (PCA) changed after 3 weeks and 6 weeks follow up.</div><div class="line" id="line-63"></div><div class="line" id="line-65"> <u> Discussion </u></div><div class="line" id="line-68"></div><div class="line" id="line-70"> PSFS score, IRD measured by RUSI andfinger width all showed improvement at the end of the study for thissubject.  Changes in patterns of musclecoordination as visualized by PCA during functional activity supports theself-reported improvements from PSFS. The study outcomes suggest that NMES maybe an appropriate physical therapy modality for reducing DRA and improvingfunctional levels in postpartum females. Future studies are warranted withlarger sample sizes to increase the generalizability of the findings in thisstudy.</div><div class="line" id="line-75"></div>

Original language	American English
State	Published - Jan 2019
Event	American Physical Therapy Association's Combined Section Meeting 2019 - Washington D.C. Duration: Jan 1 2019 → …

Conference

Conference	American Physical Therapy Association's Combined Section Meeting 2019
Period	1/1/19 → …

Keywords

Diastasis Recti
physical therapy
electrical stimulation

Disciplines

Medicine and Health Sciences
Rehabilitation and Therapy
Physical Therapy

Access to Document

CSM 2019 Poster Dec.26.18_FINAL.pdfFinal published version, 1.05 MBLicense: Unspecified

Cite this

@conference{a797c8b97c3a40f3aa326f8ed9075a11,

title = "Does electrical stimulation assist in reduction of diastasis recti in females postpartum and improve perceived functional level? Title",

abstract = " Background & Purpose Diastasis rectus abdominis (DRA) may resultin loss of strength and function of the abdominal musculature. DRA commonlyaffects women during gestation and postpartum possibly leading to a decrease infunctional activities. Natural healing of DRA may occur within 8 weekspost-partum, but resolution may not occur in up to 30% of cases. Conservativemanagement of DRA includes patient education, physical therapy, and exercise. Thereare few studies which have investigated the use of Neuromuscular ElectricalStimulation (NMES). The purpose of this study was to investigate potentialchange in inter-rectus distance, trunk muscle synergies and timing during sitto stand transfers, and patient self-reported function following use of NMES onabdominal musculature. Case Description A 7-month postpartum female gravida one,para one participated in this study. Outcome measures included: finger widthmeasurement, rehabilitative ultrasound imaging (RUSI), Patient SpecificFunctional Scale (PSFS), and surface electromyography (sEMG). All outcomemeasures were collected at initiation, 3 weeks follow up and 6 weeks.  Subject was provided a Slendertone FLEX™ NMESbelt to be worn for a 30 minute treatment 5 days/week for 6 weeks. Weeklycommunication with the subject was completed to enhance compliance with study protocol.   Finger width measurement and RUSI wereused to measure IRD. PSFS was utilized to quantify the participant’sself-assessed activity limitations and measure functional outcomes.  sEMG captured trunk, abdominal, and hipmuscle activation during sit-to-stand transfers. Outcomes Finger width measurement and RUSI wereused to measure IRD. PSFS was utilized to quantify the participant’sself-assessed activity limitations and measure functional outcomes.  sEMG captured trunk, abdominal, and hipmuscle activation during sit-to-stand transfers. Subject decreased IRD as measured viafinger-width from 2.25 to 1.25 finger-widths relaxed and 2 to 1 finger-widthscontracted. RUSI demonstrated decreases in IRD at every measured interval inboth contracted and relaxed positions. Greatest decrease in RUSI measurement ofIRD was noted at 2cm superior to the umbilicus with a 69% reduction of thesubject’s IRD from initial measurement. The subject reported an average changeof PSFS score of 2.67 points surpassing the MCID. The subject reportedincreased functional improvement in lifting and decreases in incidence ofstress incontinence. Principle Component Analysis (PCA) was applied to the sEMGdata to assess coordination of muscle recruitment. The magnitude of principlecomponent (PCA) changed after 3 weeks and 6 weeks follow up. Discussion PSFS score, IRD measured by RUSI andfinger width all showed improvement at the end of the study for thissubject.  Changes in patterns of musclecoordination as visualized by PCA during functional activity supports theself-reported improvements from PSFS. The study outcomes suggest that NMES maybe an appropriate physical therapy modality for reducing DRA and improvingfunctional levels in postpartum females. Future studies are warranted withlarger sample sizes to increase the generalizability of the findings in thisstudy.",

keywords = "Diastasis Recti, physical therapy, electrical stimulation",

author = "Jennifer Wiley and Jeanne Welch",

year = "2019",

month = jan,

language = "American English",

note = "American Physical Therapy Association's Combined Section Meeting 2019 ; Conference date: 01-01-2019",

}

TY - CONF

T1 - Does electrical stimulation assist in reduction of diastasis recti in females postpartum and improve perceived functional level? Title

AU - Wiley, Jennifer

AU - Welch, Jeanne

PY - 2019/1

Y1 - 2019/1

N2 - Background & Purpose Diastasis rectus abdominis (DRA) may resultin loss of strength and function of the abdominal musculature. DRA commonlyaffects women during gestation and postpartum possibly leading to a decrease infunctional activities. Natural healing of DRA may occur within 8 weekspost-partum, but resolution may not occur in up to 30% of cases. Conservativemanagement of DRA includes patient education, physical therapy, and exercise. Thereare few studies which have investigated the use of Neuromuscular ElectricalStimulation (NMES). The purpose of this study was to investigate potentialchange in inter-rectus distance, trunk muscle synergies and timing during sitto stand transfers, and patient self-reported function following use of NMES onabdominal musculature. Case Description A 7-month postpartum female gravida one,para one participated in this study. Outcome measures included: finger widthmeasurement, rehabilitative ultrasound imaging (RUSI), Patient SpecificFunctional Scale (PSFS), and surface electromyography (sEMG). All outcomemeasures were collected at initiation, 3 weeks follow up and 6 weeks.  Subject was provided a Slendertone FLEX™ NMESbelt to be worn for a 30 minute treatment 5 days/week for 6 weeks. Weeklycommunication with the subject was completed to enhance compliance with study protocol.   Finger width measurement and RUSI wereused to measure IRD. PSFS was utilized to quantify the participant’sself-assessed activity limitations and measure functional outcomes.  sEMG captured trunk, abdominal, and hipmuscle activation during sit-to-stand transfers. Outcomes Finger width measurement and RUSI wereused to measure IRD. PSFS was utilized to quantify the participant’sself-assessed activity limitations and measure functional outcomes.  sEMG captured trunk, abdominal, and hipmuscle activation during sit-to-stand transfers. Subject decreased IRD as measured viafinger-width from 2.25 to 1.25 finger-widths relaxed and 2 to 1 finger-widthscontracted. RUSI demonstrated decreases in IRD at every measured interval inboth contracted and relaxed positions. Greatest decrease in RUSI measurement ofIRD was noted at 2cm superior to the umbilicus with a 69% reduction of thesubject’s IRD from initial measurement. The subject reported an average changeof PSFS score of 2.67 points surpassing the MCID. The subject reportedincreased functional improvement in lifting and decreases in incidence ofstress incontinence. Principle Component Analysis (PCA) was applied to the sEMGdata to assess coordination of muscle recruitment. The magnitude of principlecomponent (PCA) changed after 3 weeks and 6 weeks follow up. Discussion PSFS score, IRD measured by RUSI andfinger width all showed improvement at the end of the study for thissubject.  Changes in patterns of musclecoordination as visualized by PCA during functional activity supports theself-reported improvements from PSFS. The study outcomes suggest that NMES maybe an appropriate physical therapy modality for reducing DRA and improvingfunctional levels in postpartum females. Future studies are warranted withlarger sample sizes to increase the generalizability of the findings in thisstudy.

AB - Background & Purpose Diastasis rectus abdominis (DRA) may resultin loss of strength and function of the abdominal musculature. DRA commonlyaffects women during gestation and postpartum possibly leading to a decrease infunctional activities. Natural healing of DRA may occur within 8 weekspost-partum, but resolution may not occur in up to 30% of cases. Conservativemanagement of DRA includes patient education, physical therapy, and exercise. Thereare few studies which have investigated the use of Neuromuscular ElectricalStimulation (NMES). The purpose of this study was to investigate potentialchange in inter-rectus distance, trunk muscle synergies and timing during sitto stand transfers, and patient self-reported function following use of NMES onabdominal musculature. Case Description A 7-month postpartum female gravida one,para one participated in this study. Outcome measures included: finger widthmeasurement, rehabilitative ultrasound imaging (RUSI), Patient SpecificFunctional Scale (PSFS), and surface electromyography (sEMG). All outcomemeasures were collected at initiation, 3 weeks follow up and 6 weeks.  Subject was provided a Slendertone FLEX™ NMESbelt to be worn for a 30 minute treatment 5 days/week for 6 weeks. Weeklycommunication with the subject was completed to enhance compliance with study protocol.   Finger width measurement and RUSI wereused to measure IRD. PSFS was utilized to quantify the participant’sself-assessed activity limitations and measure functional outcomes.  sEMG captured trunk, abdominal, and hipmuscle activation during sit-to-stand transfers. Outcomes Finger width measurement and RUSI wereused to measure IRD. PSFS was utilized to quantify the participant’sself-assessed activity limitations and measure functional outcomes.  sEMG captured trunk, abdominal, and hipmuscle activation during sit-to-stand transfers. Subject decreased IRD as measured viafinger-width from 2.25 to 1.25 finger-widths relaxed and 2 to 1 finger-widthscontracted. RUSI demonstrated decreases in IRD at every measured interval inboth contracted and relaxed positions. Greatest decrease in RUSI measurement ofIRD was noted at 2cm superior to the umbilicus with a 69% reduction of thesubject’s IRD from initial measurement. The subject reported an average changeof PSFS score of 2.67 points surpassing the MCID. The subject reportedincreased functional improvement in lifting and decreases in incidence ofstress incontinence. Principle Component Analysis (PCA) was applied to the sEMGdata to assess coordination of muscle recruitment. The magnitude of principlecomponent (PCA) changed after 3 weeks and 6 weeks follow up. Discussion PSFS score, IRD measured by RUSI andfinger width all showed improvement at the end of the study for thissubject.  Changes in patterns of musclecoordination as visualized by PCA during functional activity supports theself-reported improvements from PSFS. The study outcomes suggest that NMES maybe an appropriate physical therapy modality for reducing DRA and improvingfunctional levels in postpartum females. Future studies are warranted withlarger sample sizes to increase the generalizability of the findings in thisstudy.

KW - Diastasis Recti

KW - physical therapy

KW - electrical stimulation

M3 - Presentation

T2 - American Physical Therapy Association's Combined Section Meeting 2019

Y2 - 1 January 2019

ER -