DYNAMICS OF QUALITY OF LIFE AND ULTRASOUND PARAMETERS OF THE WHITE LINE OF THE ABDOMEN AS A CRITERION OF THE EFFECTIVENESS OF REHABILITATION INTERVENTION IN WOMEN WITH POSTPARTUM DIASTASIS RECTI

Abstract

Objective: to determine the effectiveness of a rehabilitation program for women with postpartum diastasis of the rectus abdominis muscles according to ultrasound diagnostics and quality of life indicators.Methods. 41 women aged 22.9±1.0 years were examined after vaginal delivery with signs of postpartum diastasis of the rectus abdominis muscles. The comparison group consisted of 19 women who recovered during the postpartum period independently, according to general recommendations for postpartum management. The main group consisted of 22 women who received rehabilitation interventions in the form of a physical therapy program three times a week for 8 weeks – hypopressive exercises, exercises for the trunk and abdominal muscles, kinesiological taping of the diastasis area, training on the motor regimen taking into account diastasis. The effectiveness of the program was assessed using ultrasound markers of diastasis and SF-36 questionnaire.Results of the study. In the group of women who were engaged in the developed rehabilitation program, a significant decrease in the distance between the rectus muscles was observed by 22.9% (at the level of 2 cm above the navel) and 24.7% (at the level of 5 cm above the navel) at rest, as well as 14.5% (at the level of 2 cm above the navel) and 18.2% (at the level of 5 cm above the navel) during isometric tension (p<0.05 compared to the initial parameters and indicators of the comparison group). The results of the repeated determination of quality of life according to SF-36 showed a significant improvement in both groups, with the advantage of the main group (p<0.05): improvement in physical functioning (38.0%), role-physical (39.4%), reduction in bodily pain (50.1%) and improvement in general health (42.2%). The main group also observed a more pronounced improvement in all subscales of the mental component of quality of life, in particular social functioning and role-emotional, where the improvement was 62.7% and 42.5%, respectively. The greatest improvement in the main group occurred in mental health indicators – 52.9%, which indicates a significant positive impact of rehabilitation on the psychological state of women.Conclusions. The use of rehabilitation intervention (therapeutic exercises, kinesiological taping, training in motor features) caused a statistically significant (p<0.05) improvement in the condition of the examined women in terms of diastasis recti (US) and all subscales of the SF-36, which allows us to recommend it for clinical use.