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Urogynecology (Philadelphia, Pa.) Oct 2023In recent years, pelvic-abdominal dynamics has become a research topic in the field of pelvic floor dysfunction (PFD), and the relationship between diastasis of the...
IMPORTANCE
In recent years, pelvic-abdominal dynamics has become a research topic in the field of pelvic floor dysfunction (PFD), and the relationship between diastasis of the rectus abdominis (DRA) and stress urinary incontinence (SUI) has been controversial. The study is helpful to further strengthen perinatal education, accurately identify the risk factors of SUI and DRA, and improve the quality of life of puerperae.
OBJECTIVE
This study aimed to investigate the association of SUI and DRA in women with PFD as measured by vaginal palpation or pelvic floor biofeedback machine testing.
STUDY DESIGN
A total of 301 patients diagnosed with female PFD who were 6-8 weeks postpartum at The Fifth People's Hospital of Zhuhai between May 2018 and April 2021 were enrolled. The prevalence rates and potential influencing factors of SUI and DRA were analyzed.
RESULTS
A total of 29.5% (89 of 301) of the patients were diagnosed with SUI, and 31.9% (96 of 301) were diagnosed with DRA. Binary logistic regression showed that a history of delivery ( P = 0.012; odds ratio [OR], 1.982) and vaginal delivery with perineal lacerations or episiotomy ( P = 0.016; OR, 2.187) were risk factors for SUI. High birth weight (weight>4.0 kg, P < 0.001; OR, 14.507) was a risk factor for DRA.
CONCLUSIONS
A history of delivery and vaginal delivery with perineal lacerations or episiotomy increased the risk of SUI, and high birth weight was an independent risk factor for DRA. Early intervention, including exercise therapy, manual therapy, and neuromuscular electrical stimulation, may be important for patients with PFD having these risk factors.
Topics: Pregnancy; Female; Humans; Urinary Incontinence, Stress; Rectus Abdominis; Lacerations; Birth Weight; Quality of Life; Postpartum Period; Pelvic Floor
PubMed: 37093577
DOI: 10.1097/SPV.0000000000001353 -
Frontiers in Surgery 2022Among the few studies that have examined the development of the anterior abdominal wall, several are based on incomplete "series", substituted in many cases by non-human...
PURPOSE
Among the few studies that have examined the development of the anterior abdominal wall, several are based on incomplete "series", substituted in many cases by non-human specimens.
MATERIAL AND METHODS
In total, 19 human embryos corresponding to Carnegie stages 15-23, 36 fetuses with estimated gestational ages ranging from 9 weeks to term, and eight neonates were included in this study. All specimens belong to the collection of the Department of Anatomy and Embryology at the Complutense University of Madrid.
RESULTS
The muscles of the anterior abdominal wall appear in the dorsal region at stages 15 and 16 (33-37 days). At stages 17 and 18 (41-44 days), this muscular mass grows ventrally and splits into two sheets: the external abdominal oblique muscle and the common mass of the internal abdominal oblique, and the transversus abdominis muscles, all of which end ventrally in the primitive condensation of the rectus abdominis. In embryos at stages 19 and 20 (48 days), the anterior abdominal wall continues to show an umbilical hernia in the amniotic cavity. However, a narrow neck is apparent for the first time and there is a wider anterior abdominal wall below the hernia made up of dense mesenchyme tissue without layers and showing the primordia of the umbilical canal. In embryos at stages 21, 22, and 23 (51-57 days), the abdominal muscles and aponeuroses cross the midline (linea alba) covering the rectus abdominis and pyramidalis muscles while the umbilical hernia has shrunk. In fetuses during the 9th and 10th weeks, the umbilical hernia becomes encircled by the rectus abdominis muscle, its aponeurosis, and the three layers of lateral abdominal muscles, which are more developed and covered by Camper's and Scarpa's fasciae. The inguinal canal has a course and relationships like those described in adults, with Hesselbach's ligament.
PubMed: 35433819
DOI: 10.3389/fsurg.2022.863679 -
The Journal of Physiology Apr 2019Acute hypoxia induces active expiration in rectus abdominis (RA) muscles in conscious freely moving rats, although its overall contribution is smaller than in internal...
KEY POINTS
Acute hypoxia induces active expiration in rectus abdominis (RA) muscles in conscious freely moving rats, although its overall contribution is smaller than in internal oblique (IO) muscles. Tonically active and silent RA motoneurons were identified in in vitro preparations of rat spinal cords. Sustained hypoxia (SH) increased the synaptic strength and induced morphological changes in tonically active RA motoneurons. Expiratory RA motoneurons were recorded in the in situ preparation and SH enhanced both the excitability and the synaptic transmission in those firing during the stage 2 expiration. The present study contributes to a better understanding of the mechanisms involved in SH recruitment of RA motoneurons to induce active expiration in rats.
ABSTRACT
Rectus abdominis (RA) motoneurons translate the complex respiratory brainstem inputs into effective muscle contractions. Despite their fundamental role in respiration, their functional and morphological properties are not fully understood. In the present study, we investigated for the first time the contribution of RA muscle to active expiration and characterized RA motoneurons regarding their electrical, molecular and morphological profiles in control rats and in rats submitted to sustained hypoxia (SH), which induces chronic recruitment of abdominal muscles. Electromyographic experiments in conscious freely moving control rats and SH rats showed that RA contributes to active expiration induced by acute hypoxia, although its contribution is smaller than in internal oblique muscles. in vitro whole-cell patch clamp recordings from RA motoneurons revealed two populations of cells: tonically active and silent. SH induced hyperexcitability in the tonically active cells by changing their action potential properties, and EPSCs. Three-dimensional morphological reconstructions of these cells showed that SH increased the dendritic complexity, stimulated the appearance of dendrite spines, and increased the somatic area and volume. Physiologically identified RA motoneurons, firing in two distinct phases of expiration, were recorded in the brainstem-spinal cord in situ preparation of rats. SH increased the firing frequency and EPSCs of neurons firing during stage 2 expiration. Taken together, our results show that RA motoneurons reconfigure their biophysical properties, morphology and synaptic strength to produce an appropriate expiratory drive in response to SH in rats.
Topics: Animals; Brain Stem; Electrophysiological Phenomena; Male; Motor Neurons; Muscle, Skeletal; Oxygen; Patch-Clamp Techniques; Rats; Rats, Wistar; Respiratory Physiological Phenomena; Spinal Cord
PubMed: 30747446
DOI: 10.1113/JP277030 -
Journal of Lifestyle Medicine Jan 2021Rectus abdominis is the main core muscle. Weakness or any alteration in it may increase the pressure over the lower back, in obese women diastasis of rectus abdominis...
BACKGROUND
Rectus abdominis is the main core muscle. Weakness or any alteration in it may increase the pressure over the lower back, in obese women diastasis of rectus abdominis muscle found to be very common condition. Therefore, there may be a correlation between diastasis of rectus abdominis muscle and low back pain in obese women that needs to be explored, as there is no literature available.
METHODS
In this study, 72 female subjects with Body Mass Index <30 kg/m were recruited by snowball sampling method. Demographic (name, age) and anthropometric characteristics (height, weight and body mass index) were recorded. The separation in the rectus abdominis muscle was assessed with vernier calliper.
RESULTS
Total subjects were included in the study; all the subjects were Female without any recent abdominal surgical history. The subjects included in the study with age of 30 years to 55 years old with body mass index of the included females must be (30-30.9) kg/m i.e. women must come under obese category. Diastasis of rectus abdominis muscle was another variable used that must be present in each women. Low back pain was also used as the variable that may be present or may not be present in the women with diastasis of rectus abdominis muscle. The collected data were analysed by the appropriate statistical analysis tools. The p-value was found more than 0.05 (the alpha level set was less than 0.05) which is non-significant.
CONCLUSION
The study concluded a non-significant correlation between the diastasis of rectus abdominis muscle and low back pain in obese women. The present study concludes that it is not necessary that all obese women with low back pain always propose to have diastasis of rectus abdominis muscle.
PubMed: 33763341
DOI: 10.15280/jlm.2021.11.1.38 -
BMC Women's Health Nov 2023Pilates is expected to have a positive effect on women with weakened abdominal muscles after childbirth. Pilates may have a beneficial effect on the structure and...
BACKGROUND
Pilates is expected to have a positive effect on women with weakened abdominal muscles after childbirth. Pilates may have a beneficial effect on the structure and function of the abdominal muscles in pregnant women. Therefore, the objective of this study was to investigate the effects of Pilates on inter-recti distance, thickness of the rectus abdominis, waist circumference, and abdominal muscle endurance in primiparous women.
METHODS
Thirty-five primiparous postpartum women were assigned to either the Pilates exercise group (n = 20) or the control group (n = 15). Pilates was undertaken by the exercise group for 50 min/day, 5 days/week, for 4 weeks. The control group maintained their daily activities without any intervention. The inter-recti distance was measured at three locations along the linea alba, and the thickness of the rectus abdominis was measured using ultrasound. Abdominal muscle endurance was measured using a repeated 1-min curl-up test. Waist circumference was also measured.
RESULTS
The exercise group showed significant improvements from baseline in inter-recti distance, waist circumference, and abdominal muscle endurance (p < 0.05). The control group showed no significant improvement in these variables. Compared with the control group, the exercise group showed significantly improved performance in terms of inter-recti distance, waist circumference, and abdominal muscle endurance (p < 0.05).
CONCLUSIONS
The results of this study demonstrate that Pilates was effective in reducing inter-recti distance and waist circumference and improving abdominal muscle endurance in primiparous postpartum women. Pilates is considered an effective exercise for improving muscle structure and function in primiparous postpartum women, helping in the recovery from, and preventing, diastasis rectus abdominis.
Topics: Female; Humans; Pregnancy; Rectus Abdominis; Waist Circumference; Abdominal Muscles; Postpartum Period; Abdominal Wall
PubMed: 38008749
DOI: 10.1186/s12905-023-02775-5 -
Medicine Nov 2023During pregnancy and postpartum, changes in biomechanics can cause dysfunctions in the myofascial system, such as rectus abdominis diastasis, various types of pain, and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
During pregnancy and postpartum, changes in biomechanics can cause dysfunctions in the myofascial system, such as rectus abdominis diastasis, various types of pain, and pelvic floor dysfunction. These common postpartum problems seriously threaten women's health. Myofascial therapy, as an effective means of improving biomechanics, has no unified understanding of its therapeutic effects on postpartum functional disorders. This study aims to systematically evaluate the rehabilitative effects of myofascial therapy on postpartum rectus abdominis diastasis, low back and leg pain, and pelvic floor dysfunction through a meta-analysis of published randomized controlled trials.
METHODS
A systematic literature search of databases in Chinese and English was performed through May 2023. The treatment methods were randomized controlled studies using myofascial therapy in the treatment of rectus abdominis separation, lumbo-leg pain, and pelvic floor dysfunction. The main outcome indicators were abdominal circumference, rectus abdominis separation distance, visual analogue pain score, pelvic floor muscle potential, ability to live daily activities, number of events, and treatment effectiveness.
RESULTS
There were 22 studies, including 2235 patients. The result showed that compared with control group, myofascial therapy demonstrated to reduce abdominal circumference and rectus abdominis separation index, improve lumbar function significantly, and decrease urinary incontinence and pelvic organ prolapse. In the myofascial therapy group, pelvic floor muscle strength was significantly enhanced, anterior/posterior resting potential of pelvic floor muscle was significantly decreased, and pelvic floor muscle potential was enhanced. Compared with the control group, the number of patients with various types of pain and pain scores were significantly reduced after myofascial therapy. When myofascial therapy lasted <4 weeks, pain relief was greater. In the myofascial therapy group, the ability to perform daily activities was significantly improved. An analysis of the effectiveness of the treatment showed that after myofascial therapy, the patient's symptoms improved significantly. There also saw low heterogeneity among all outcomes.
CONCLUSION
The results suggested that myofascial therapy could effectively reduce rectus abdominis separation, relieve pelvic floor muscle dysfunction, enhance lumbar function, relieve pain, and improve the ability of daily living activities. All the data demonstrated that myofascial therapy had a good therapeutic effect on postpartum dysfunction.
Topics: Pregnancy; Female; Humans; Rectus Abdominis; Leg; Postpartum Period; Abdominal Muscles; Puerperal Disorders; Pelvic Pain; Randomized Controlled Trials as Topic
PubMed: 37932976
DOI: 10.1097/MD.0000000000035761 -
Journal of Cachexia, Sarcopenia and... Jun 2021In vivo muscle protein synthesis rates are typically assessed by measuring the incorporation rate of stable isotope labelled amino acids in skeletal muscle tissue...
BACKGROUND
In vivo muscle protein synthesis rates are typically assessed by measuring the incorporation rate of stable isotope labelled amino acids in skeletal muscle tissue collected from vastus lateralis muscle. It remains to be established whether muscle protein synthesis rates in the vastus lateralis are representative of muscle protein synthesis rates of other muscle groups. We hypothesized that post-absorptive muscle protein synthesis rates differ between vastus lateralis and rectus abdominis, pectoralis major, or temporalis muscle in vivo in humans.
METHODS
Twenty-four patients (62 ± 3 years, 42% female), scheduled to undergo surgery, participated in this study and underwent primed continuous intravenous infusions with l-[ring- C ]-phenylalanine. During the surgical procedures, serum samples were collected, and muscle tissue was obtained from the vastus lateralis as well as from the rectus abdominis, pectoralis major, or temporalis muscle. Fractional mixed muscle protein synthesis rates (%/h) were assessed by measuring the incorporation of l-[ring- C ]-phenylalanine into muscle tissue protein.
RESULTS
Serum l-[ring- C ]-phenylalanine enrichments did not change throughout the infusion period. Post-absorptive muscle protein synthesis rates calculated based upon serum l-[ring- C ]-phenylalanine enrichments did not differ between vastus lateralis and rectus abdominis (0.032 ± 0.004 vs. 0.038 ± 0.003%/h), vastus lateralis and pectoralis major, (0.025 ± 0.003 vs. 0.022 ± 0.005%/h) or vastus lateralis and temporalis (0.047 ± 0.005 vs. 0.043 ± 0.005%/h) muscle, respectively (P > 0.05). When fractional muscle protein synthesis rates were calculated based upon tissue-free l-[ring- C ]-phenylalanine enrichments as the preferred precursor pool, muscle protein synthesis rates were significantly higher in rectus abdominis (0.089 ± 0.008%/h) compared with vastus lateralis (0.054 ± 0.005%/h) muscle (P < 0.01). No differences were observed between fractional muscle protein synthesis rates in vastus lateralis and pectoralis major (0.046 ± 0.003 vs. 0.041 ± 0.008%/h) or vastus lateralis and temporalis (0.073 ± 0.008 vs. 0.083 ± 0.011%/h) muscle, respectively.
CONCLUSIONS
Post-absorptive muscle protein synthesis rates are higher in rectus abdominis when compared with vastus lateralis muscle. Post-absorptive muscle protein synthesis rates do not differ between vastus lateralis and pectoralis major or temporalis muscle. Protein synthesis rates in muscle tissue samples obtained during surgery do not necessarily represent a good proxy for appendicular skeletal muscle protein synthesis rates.
Topics: Female; Humans; Male; Muscle Proteins; Phenylalanine; Protein Biosynthesis; Quadriceps Muscle; Rectus Abdominis
PubMed: 33951313
DOI: 10.1002/jcsm.12701 -
Anatomy & Cell Biology May 2024Transversus abdominis release (TAR) is a myofascial release technique which helps in surgical repair of large ventral abdominal wall defects. In this procedure, the...
Transversus abdominis release (TAR) is a myofascial release technique which helps in surgical repair of large ventral abdominal wall defects. In this procedure, the medial margin of muscular part of transversus abdominis (TA) is of great importance. Hence, the authors sought to describe the extent of medial margin of TA muscle. The surgical steps of TAR were performed in 10 formalin-fixed cadavers and distance between medial margin of TA muscle, lateral margin of rectus abdominis, to linea alba at five anatomical levels were documented respectively. The distance between the inferior epigastric vessels and the medial border of TA muscle was also noted. The TA muscle was within the posterior rectus sheath in all cadavers, at the xiphisternum (R, 61.6 mm; L, 58.9 mm), and at midway between xiphisternum and umbilicus (R, 25.4 mm; L, 27.1 mm). The TA muscle exited the posterior rectus sheath between this point and the umbilicus. The mean incongruity at the next three levels were -24.6 mm, -24.9 mm, and -22.9 mm respectively on the right and -21.4 mm, -19.9 mm, and -18.9 mm respectively on the left. The mean distance between the medial border of TA and inferior epigastric vessels was 18.9 mm on the right and 17.2 mm on the left. The muscular part of TA was incorporated within the posterior rectus sheath above the umbilicus, and it completely exited the rectus sheath at the umbilicus. This is contrary to the traditional understanding of posterior rectus sheath formation.
PubMed: 38797746
DOI: 10.5115/acb.23.305 -
Academic Radiology Mar 2022The rectus abdominis muscle exhibits early and significant muscle atrophy, which has largely been characterized using ultrasound measured muscle thickness. However, the...
RATIONALE AND OBJECTIVES
The rectus abdominis muscle exhibits early and significant muscle atrophy, which has largely been characterized using ultrasound measured muscle thickness. However, the validity of rectus abdominis muscle thickness as a metric of muscle size has not been established, limiting precise interpretation of age-related changes. In a heterogeneous cohort of women and men, our objectives were to: (1) evaluate the association between rectus abdominis muscle thickness and cross-sectional area (CSA), and (2) examine if the visceral adipose tissue (VAT) compartment confounds the validity of rectus abdominis muscle thickness.
MATERIALS AND METHODS
Abdominal computed tomography scans of the third lumbar vertebrae from clinical and healthy populations were used to evaluate rectus abdominis thickness and CSA, and VAT CSA. Computed tomography scans were utilized due to the limited field of view of ultrasound imaging to capture the rectus abdominis CSA.
RESULTS
A total of 348 individuals (31% women) were included in this analysis, with a mean ± standard deviation age and body mass index of 51.2 ± 15.4 years and 28.0 ± 5.1 kg/m, respectively. Significant correlations were observed between rectus abdominis thickness and CSA for women (r = 0.758; p < 0.001) and men (r = 0.688; p < 0.001). Independent of age, VAT CSA was negatively associated with rectus abdominis thickness in men (p = 0.011), but not women (p = 0.446).
CONCLUSION
These data support the use of rectus abdominis muscle thickness as a measurement of muscle size in both women and men; however, the VAT compartment may confound its validity to a minor extent in men.
Topics: Body Mass Index; Female; Humans; Intra-Abdominal Fat; Male; Rectus Abdominis; Tomography, X-Ray Computed; Ultrasonography
PubMed: 34253439
DOI: 10.1016/j.acra.2021.06.005 -
Journal of Plastic Surgery and Hand... 2023The extended vertical rectus abdominis myocutaneous (eVRAM) flap has been proposed for reconstruction of large pelviperineal defects where traditional VRAM flap could be...
The extended vertical rectus abdominis myocutaneous (eVRAM) flap has been proposed for reconstruction of large pelviperineal defects where traditional VRAM flap could be insufficient. To compare the dimensions of VRAM and eVRAM flaps an anatomical study was performed. Ten VRAM and ten eVRAM flaps were dissected in ten fresh adult cadavers. Length, width and volume of all the flaps were measured. Length and volume were significantly larger in eVRAM flap compared to VRAM flap (36.55 cm 30.15, =.005; and 315.5 244 mL, =.012, respectively). No differences were observed in flap width. The eVRAM flap could be a better option than traditional VRAM for reconstruction of big pelviperineal defects when bulkier tissue, larger skin paddle and/or longer arch of rotation are needed for reconstruction.
Topics: Adult; Humans; Myocutaneous Flap; Rectus Abdominis; Skin; Cadaver; Foot
PubMed: 35034570
DOI: 10.1080/2000656X.2021.2024554