Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Background: Diastasis recti (DR), a separation of the abdominal muscles, occurs when women are pregnant as their abdominals become over-stretched towards the end of pregnancy. This separation persists post-partum, and women who have DR often end up with poor abdominal muscle function, pelvic pain, and bladder leakage. Physiotherapists often prescribe abdominal binding and exercise therapy to assist in recovery from DR, however, the effectiveness of these approaches has never been adequately investigated. Purpose: This study will investigate the impact of physiotherapy interventions on improving the signs (abdominal muscle separation, weakness) and symptoms (functional abilities) of women affected by DR. It will also investigate whether improvements in DR (measured using ultrasound imaging) are associated with improvements in abdominal muscle function or functional abilities. Methods: One hundred women with DR will undergo testing to measure abdominal muscle dimensions and strength, and will complete a physical functioning questionnaire. They will be randomly assigned to one of four groups: 1)abdominal binding, 2)supervised exercise therapy, 3)abdominal binding & supervised exercise therapy, 4) no intervention. Abdominal muscle dimensions, strength, and functional questionnaires will be repeated at the end of the 12 week intervention period, and at a 6 month follow up. Hypotheses: We expect that all interventions will be more effective in improving DR signs and symptoms than no intervention, and that the combination of interventions will be more effective than either intervention alone. Significance: This study may provide evidence for the best approach to the conservative management of DR. The results of this study will inform the development of an online educational tool for best practice post-partum care, and will be disseminated to physicians and midwives to guide their management and referral of women with DR.