Effect of Pelvic Floor Exercises and Diaphragmatic Activation versus Split Tummy Exercise Program on Inter-recti Distance, Strength and Quality of Life in Diastasis Recti: A Research Protocol

Introduction: Diastasis Recti Abdominis (DRA) is characterised by an increased separation of the rectus abdominis muscles, which is accompanied by the extension of the linea alba tissue and weakness of the abdominal wall. Among women, DRA is prevalent both during pregnancy and in the postpartum period. There is a lack of knowledge regarding the prevalence, risk factors and rehabilitation of this condition. Need of the study: Diastasis Recti can lead to an increased distance between the rectus abdominis muscles and weaken the abdominal muscles, which may contribute to pelvic floor dysfunction and affect its function, ultimately resulting in a reduced quality of life. It has also been noted that Urinary Incontinence (UI), Pelvic Organ Prolapse (POP) and faecal incontinence occur more frequently in women who have DRA. In this study, the combined effect of pelvic floor exercises with abdominal activation and the Split Tummy Exercise Program (STEP) can be a more effective management strategy in reducing diastasis recti and thereby improving abdominal muscle strength and quality of life. Aim: To compare the effects of pelvic floor exercises with diaphragmatic activation and the Split Tummy Workout Program on strength, overall quality of life and inter-recti distance in patients with diastasis recti. Materials and Methods: The present study is a comparative study in which a simple random sampling technique will be employed on participants allocated by a sequentially numbered opaque sealed envelope technique. The total duration of the study will be one year from June 2024 to June 2025, with a total of 60 participants conducted at Datta Meghe Institute of Higher Education and Research, Deemed to be University, Wardha, Maharashtra, India. This research will be conducted in the Department of Community Health Physiotherapy and the Department of Obstetrics and Gynaecology, based on the inclusion criteria of the study. Group A will receive a four-week exercise program that includes pelvic floor exercises combined with abdominal activation, while Group B will follow the STEP program. Outcome measures will include a Digital Calliper, Posterior Pelvic Pain Provocation Test, Visual Analogue Scale (VAS), Sphygmomanometer and Health-Related Quality of Life Scale (HRQOL), which will be performed at baseline and at the last session after four weeks of rehabilitation.