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Published in: Insights into Imaging 1/2023

Open Access 01-12-2023 | Diastasis Recti | Educational Review

Technical aspects of inter-recti distance measurement with ultrasonographic imaging for physiotherapy purposes: the scoping review

Authors: Agnieszka Opala-Berdzik, Magdalena Rudek-Zeprzałka, Justyna Niesporek, Maciej Cebula, Jan Baron, Katarzyna Gruszczyńska, Augusto Gil Pascoal, Patrícia Mota, Daria Chmielewska

Published in: Insights into Imaging | Issue 1/2023

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Abstract

Background

Inter-recti distance (IRD) measurement using musculoskeletal USI has been used in physiotherapy research, in particular, to investigate pregnancy-related diastasis recti abdominis (DRA) and to seek its effective treatment methods. Severe and untreated diastasis may result in the formation of umbilical or epigastric hernias.

Objective

This study aimed to systematically map physiotherapy-related research articles that included descriptions of IRD measurement procedures using USI to present their similarities and differences, and formulate recommendations on the procedure.

Design

A scoping review was conducted according to PRISMA-ScR guidelines, including 49 of 511 publications from three major databases. Publications were selected and screened by two independent reviewers whose decisions were consulted with a third reviewer. The main synthesized data items were: the examinees’ body position, breathing phase, measurement sites, and DRA screening methods. The final conclusions and recommendations were the result of a consensus between seven reviewers from four research centers.

Results

Studies used 1–5 measurement sites that were differently determined. IRD was measured at the umbilicus (n = 3), at its superior (n = 16) and/or inferior border (n = 9), and at different levels: between 2 and 12 cm above the umbilicus, or a third of the distance and halfway between the umbilicus and xiphoid (n = 37); between 2 and 4.5 cm below the umbilicus or halfway between the umbilicus and pubis (n = 27). Different approaches were used to screen subjects for DRA.

Conclusions

The discrepancies between the measurement procedures prevent between-study comparisons. The DRA screening method should be standardized. IRD measurement protocol standardization has been proposed.

Critical relevance statement

This scoping review indicates that the inter-recti distance measurement procedures using ultrasound imaging differ between studies, preventing between-study comparisons. Based on the results synthesis, the measurement protocol standardization has been proposed.

Key points

  • The inter-recti distance measurement procedures using USI differ between studies.
  • Proposed standardization concerns body position, breathing phase, measurements number per location.
  • Determination of measurement locations considering individual linea alba length is suggested.
  • Recommended locations: umbilical top, ½ of umbilical top-xiphoid, ¼ of umbilical top-xiphoid/pubis distances.
  • Diastasis recti abdominis diagnostic criteria are needed for proposed measurement locations.

Graphical Abstract

Appendix
Available only for authorised users
Literature
59.
go back to reference Romero-Morales C, Martín-Llantino PJ, Calvo-Lobo C, et al. (2018) Effectiveness of eccentric exercise and a vibration or cryotherapy program in enhancing rectus abdominis muscle thickness and inter-rectus distance in patients with chronic mid-portion achilles tendinopathy: a randomized clinical trial. Int J Med Sci 15:1764–1770. https://doi.org/10.7150/ijms.28656CrossRefPubMedPubMedCentral Romero-Morales C, Martín-Llantino PJ, Calvo-Lobo C, et al. (2018) Effectiveness of eccentric exercise and a vibration or cryotherapy program in enhancing rectus abdominis muscle thickness and inter-rectus distance in patients with chronic mid-portion achilles tendinopathy: a randomized clinical trial. Int J Med Sci 15:1764–1770. https://​doi.​org/​10.​7150/​ijms.​28656CrossRefPubMedPubMedCentral
70.
go back to reference Starzec-Proserpio M, Lipa D, Szymański J, Szymańska A, Kajdy A, Baranowska B (2022) Association among pelvic girdle pain, diastasis recti abdominis, pubic symphysis width, and pain catastrophizing: a matched case-control study. Phys Ther 102(4):pza311. https://doi.org/10.1093/ptj/pzab311CrossRef Starzec-Proserpio M, Lipa D, Szymański J, Szymańska A, Kajdy A, Baranowska B (2022) Association among pelvic girdle pain, diastasis recti abdominis, pubic symphysis width, and pain catastrophizing: a matched case-control study. Phys Ther 102(4):pza311. https://​doi.​org/​10.​1093/​ptj/​pzab311CrossRef
74.
77.
go back to reference Huge B, Kisner C (2018) Women’s health: obstetrics and pelvic floor. In: Kisner C, Colby L, Borstad J (eds) Therapeutic exercise: foundations and techniques, 7e. McGraw Hill, New York Huge B, Kisner C (2018) Women’s health: obstetrics and pelvic floor. In: Kisner C, Colby L, Borstad J (eds) Therapeutic exercise: foundations and techniques, 7e. McGraw Hill, New York
78.
go back to reference Noble E (2003) The abdominal muscles. In: Noble E (ed) Essential exercises for the childbearing year. A guide to health and comfort before and after your baby is born 4e. New Life Images, Union City Noble E (2003) The abdominal muscles. In: Noble E (ed) Essential exercises for the childbearing year. A guide to health and comfort before and after your baby is born 4e. New Life Images, Union City
79.
go back to reference Candido G, Lo T, Janssen PA (2005) Risk factors for diastasis of the recti abdominis. J Assoc Chart Physiother Women’s Health 97:49–54 Candido G, Lo T, Janssen PA (2005) Risk factors for diastasis of the recti abdominis. J Assoc Chart Physiother Women’s Health 97:49–54
83.
go back to reference Ainscough-Potts AM, Morrissey MC, Critchley D (2006) The response of the transverse abdominis and internal oblique muscles to different postures. Man Ther 11:54–60CrossRefPubMed Ainscough-Potts AM, Morrissey MC, Critchley D (2006) The response of the transverse abdominis and internal oblique muscles to different postures. Man Ther 11:54–60CrossRefPubMed
Metadata
Title
Technical aspects of inter-recti distance measurement with ultrasonographic imaging for physiotherapy purposes: the scoping review
Authors
Agnieszka Opala-Berdzik
Magdalena Rudek-Zeprzałka
Justyna Niesporek
Maciej Cebula
Jan Baron
Katarzyna Gruszczyńska
Augusto Gil Pascoal
Patrícia Mota
Daria Chmielewska
Publication date
01-12-2023
Publisher
Springer Vienna
Keyword
Diastasis Recti
Published in
Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1186/s13244-023-01443-4

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