Effect Of Real-time Ultrasound Feedback Training On Iner-recti Distance And Activation Of Transverse Abdominis After Postpartum

1.Research backgroundDiastasis recti abdominis is a disease exhibiting an increased distance of the rectus margin along the white line,characterized by the white line and the abdominal wall being stretched thinner and wider,accompanied by relaxation of the abdominal muscles.Diastasis recti abdominis which is not only affects the body appearance,but also may reduce spinal stability,lead to lower back pain.The self-healing ability of diastasis recti abdominis is limited,and the incidence rate can be up to 50%～60%within 6 weeks to 6 months after delivery.There is a lack of consensus on the separation of rectus abdominis.Previous studies have proved that the abdominal core muscle group training can effectively shorten the rectus abdominis spacing.The transversus abdominis muscle,as a deep abdominal core muscle,is involved in the formation of the posterior sheath of the rectus abdominis.Preactivation and strengthen training of transversus abdominis can effectively promote the recovery of rectus abdominis separation spacing.It has been reported that abdominal hollowing exercise,as a basic procedure for core stability training,can effectively activate the transversus abdominis muscle.However,most previous studies on abdominal hollowing exercise have been limited to healthy adults,and the role of women with postpartum rectus abdominis separation is unclear.High frequency ultrasound has a high resolution for human soft tissue,and can show the functional state of muscle in real time and dynamically.It can guide patients to master the target movements in a shorter time,thus making the training more scientific and effective.However,there are no studies using real-time ultrasound feedback in patients with postpartum diastasis recti abdominis.Therefore,we hope to conduct transverse abdominis activation training(abdominal hollowing exercise)through real-time ultrasound feedback,improve transverse abdominis muscle contraction function and restore rectus abdominis spacing.We hope to explore new,more scientific and efficient treatment methods for the rehabilitation treatment of postpartum rectus abdominis separation.2.PurposeTo observe the effect of real-time ultrasound feedback of abdominal hollowing exercise on the efficacy of patients with transverse abdominis activation and postpartum rectus abdominis separation.3.Methods62 patients with>20mm from December 2021 to July 2022 were selected and randomly divided into two groups of 31 patients receiving real-time ultrasound feedback therapy(trial group)and verbal and tactile feedback therapy(control group),20 minutes each time,twice a week.Both groups received neuromuscular electrical stimulation,manual therapy,and home training lasting for 4 weeks.Home training consisted of 6 groups of movements targeting the abdominal core muscle group for 30 minutes each,three times a week.And measured abdominal muscle thickness and inter-recti distance before treatment after 2 weeks and after 4 weeks by high frequency ultrasound.On this basis,the difference value of abdominal circumference and transverse abdominis activation were calculated.4.ResultsAfter treatment,the transverse abdominal muscle thickness and activation increased in both groups.Also,the abdominal circumference decreased significantly in both groups(P<0.05).Compared with the control group at the same time,the test group had better transverse abdominal muscle activation and more decreased in abdominal circumference after 2 weeks of treatment(P<0.05).After 4 weeks of treatment,the inter-recti distance decreased significantly in the test group(P<0.05).Both static transverse abdominis thickness and dynamic transverse abdominis thickness increased significantly(P<0.05).However,there was no significant difference in the degree of transverse abdominal muscle activation and abdominal circumference between the two groups(P>0.05).5.ConclusionsThe abdominal hollowing exercise based on real-time ultrasound feedback can promote the activation of transversus abdominis muscle and increase muscle thickness,which help the postpartum iner-recti distance recovery.