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Journal of Physiotherapy Jul 2023What is the effect of a 12-week, home-based, abdominal exercise program containing head lifts and abdominal curl-ups on inter-recti distance (IRD) in women with... (Randomized Controlled Trial)
Randomized Controlled Trial
Curl-up exercises improve abdominal muscle strength without worsening inter-recti distance in women with diastasis recti abdominis postpartum: a randomised controlled trial.
QUESTION
What is the effect of a 12-week, home-based, abdominal exercise program containing head lifts and abdominal curl-ups on inter-recti distance (IRD) in women with diastasis recti abdominis (DRA) 6 to 12 months postpartum? What is the effect of the program on: observed abdominal movement during a curl-up; global perceived change; rectus abdominis thickness; abdominal muscle strength and endurance; pelvic floor disorders; and low back, pelvic girdle and abdominal pain?
DESIGN
This was a two-arm, parallel-group, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis.
PARTICIPANTS
Seventy primiparous or multiparous women 6 to 12 months postpartum, having a single or multiple pregnancy following any mode of delivery, with a diagnosis of DRA (IRD > 28 mm at rest or > 25 mm during a curl-up).
INTERVENTION
The experimental group was prescribed a 12-week standardised exercise program including head lifts, abdominal curl-ups and twisted abdominal curl-ups 5 days a week. The control group received no intervention.
OUTCOME MEASURES
The primary outcome measure was change in IRD measured with ultrasonography. Secondary outcomes were: observed abdominal movement during a curl-up; global perceived change; rectus abdominis thickness; abdominal muscle strength and endurance; pelvic floor disorders; and low back, pelvic girdle and abdominal pain.
RESULTS
The exercise program did not improve or worsen IRD (eg, MD 1 mm at rest 2 cm above the umbilicus, 95% CI -1 to 4). The program improved rectus abdominis thickness (MD 0.7 mm, 95% CI 0.1 to 1.3) and strength (MD 9 Nm, 95% CI 3 to 16) at 10 deg; its effects on other secondary outcomes were trivial or unclear.
CONCLUSION
An exercise program containing curl-ups for women with DRA did not worsen IRD or change the severity of pelvic floor disorders or low back, pelvic girdle or abdominal pain, but it did increase abdominal muscle strength and thickness.
REGISTRATION
NCT04122924.
Topics: Pregnancy; Female; Humans; Rectus Abdominis; Pelvic Floor Disorders; Abdominal Muscles; Postpartum Period; Exercise Therapy; Diastasis, Muscle; Abdominal Pain
PubMed: 37286390
DOI: 10.1016/j.jphys.2023.05.017 -
Heliyon Oct 2023Diastasis recti abdominis (DRA) affects a significant number of postpartum women, while its treatments are still under debate. This study aimed to systematically... (Review)
Review
Diastasis recti abdominis (DRA) affects a significant number of postpartum women, while its treatments are still under debate. This study aimed to systematically evaluate the effectiveness of rehabilitation training programs for postpartum DRA treatment. Four databases were systematically searched to identify eligible studies published up to February 1, 2023. We followed the PRISMA for scoping reviews guideline in this study. The characteristics and the main findings of the included studies were extracted. Sixteen studies enrolling 1129 women during the ante- and/or postnatal period were included. The common rehabilitation training for DRA included physical exercise, non-exercise physical therapy, acupuncture, and electrotherapy. The presence of DRA could be diagnosed by ultrasound, caliper, or palpation, of which ultrasound had the best reliability. Besides, these assessments could also be used for evaluating the therapeutic efficacy after the rehabilitation training programs. Several studies concluded that patients with DRA could be effectively improved by specific interventions. But a few included studies revealed rehabilitation training might be not more effective than no interventions when treating DRA. For example, some investigators did not recommend physical exercise for DRA patients due to this intervention during pregnancy kept the linea alba less stressed by maintaining abdominal tone, strength, and control, and therefore might aggravate DRA. However, it should be noted that this evidence was derived from limited studies (16/60, 27 % papers) with small samples. To some extent, women with postpartum DRA can benefit from the specific rehabilitation regimen by alleviating postpartum inter-rectus distance. Further research is still warranted to propose strategies for improving postpartum DRA.
PubMed: 37867827
DOI: 10.1016/j.heliyon.2023.e20956 -
Medicine and Science in Sports and... Dec 2023This study aimed to compare the effects of free-weight and machine-based resistance training on strength, hypertrophy, and joint discomfort.
PURPOSE
This study aimed to compare the effects of free-weight and machine-based resistance training on strength, hypertrophy, and joint discomfort.
METHODS
Thirty-eight resistance-trained men participated in an 8-wk resistance program allocated into free-weight ( n = 19) or machine-based ( n = 19) groups. Training variables were identical for both modalities, so they only differed in the use of barbells or machines to execute the full squat, bench press, prone bench pull, and shoulder press exercises. The velocity-based method was implemented to accurately adjust the intensity throughout the program. Strength changes were evaluated using eight velocity-monitored loading tests (four exercises × two modalities) and included the relative one-repetition maximum (1RM Rel ), as well as the mean propulsive velocity against low (MPV Low ) and high (MPV High ) loads. Ultrasound-derived cross-sectional area of quadriceps (proximal and distal regions), pectoralis major, and rectus abdominis was measured to examine hypertrophy. Complementarily, Western Ontario and McMaster Universities and Disabilities of the Arm, Shoulder and Hand questionnaires were administrated to assess changes in lower- and upper-limb joint discomfort. Outcomes were compared using ANCOVA and percentage of change (∆) statistics.
RESULTS
Each group significantly ( P < 0.001) increased 1RM Rel , MPV Low , and MPV High for both modalities tested, but especially in the one they trained. When considering together the eight exercises tested, strength changes for both modalities were similar (∆ differences ≤1.8%, P ≥ 0.216). Likewise, the cross-sectional area of all the muscles evaluated was significantly increased by both modalities, with no significant differences between them (∆ difference ≤2.0%, P ≥ 0.208). No between-group differences ( P ≥ 0.144) were found for changes in stiffness, pain, and functional disability levels, which were reduced by both modalities.
CONCLUSIONS
Free-weight and machine-based modalities are similarly effective to promote strength and hypertrophy without increasing joint discomfort.
Topics: Male; Humans; Muscle Strength; Quadriceps Muscle; Posture; Exercise; Hypertrophy
PubMed: 37535335
DOI: 10.1249/MSS.0000000000003271 -
Rozhledy V Chirurgii : Mesicnik... 2024Spigelian hernia is a rare type of abdominal wall hernias which are often diagnosed when incarcerated. These hernias typically develop at the crossing point of the...
INTRODUCTION
Spigelian hernia is a rare type of abdominal wall hernias which are often diagnosed when incarcerated. These hernias typically develop at the crossing point of the arcuate line and lateral portion of rectus abdominis muscle.
CASE REPORT
We present the case of a 44-year-old female patient admitted to our surgery unit for a painful lump in her right mesogastrium. Incarcerated atypical hernia in the right mesogastrium was suspected based on completed imaging assessments. Spigelian hernia was confirmed by preoperative findings. Interestingly, the patient applied interferon (multiple sclerosis therapy) at the site of the lump, which is why the diagnosis of lipodystrophy had been considered.
CONCLUSION
In general, the diagnosis of Spigelian hernia is difficult. From the anatomical point of view the clinical finding is not always specific. The risk of incarceration is relatively high, and thus even clinically silent findings are indicated for surgery.
Topics: Humans; Female; Adult; Hernia, Ventral; Hernia, Abdominal
PubMed: 38886104
DOI: 10.33699/PIS.2024.103.3.96-99 -
Current Pain and Headache Reports Oct 2023The purpose of this review is to provide an up-to-date description and overview of the rapidly growing literature pertaining to techniques and clinical applications of... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to provide an up-to-date description and overview of the rapidly growing literature pertaining to techniques and clinical applications of chest wall and abdominal fascial plane blocks in managing perioperative pain.
RECENT FINDINGS
Clinical evidence suggests that regional anesthesia blocks, including fascial plane blocks, such as pectoralis, serratus, erector spinae, transversus abdominis, and quadratus lumborum blocks, are effective in providing analgesia for various surgical procedures and have more desirable side effect profile when compared to traditional neuraxial techniques. They offer advantages such as reduced opioid consumption, improved pain control, and decreased opioid-related side effects. Further research is needed to establish optimal techniques and indications for these blocks. Presently, they are a vital instrument in a gamut of multimodal analgesia options, especially when there are contraindications to neuraxial or para-neuraxial procedures. Ultimately, clinical judgment and provider skill set determine which blocks-alone or in combination-should be offered to any patient.
Topics: Humans; Thoracic Wall; Analgesics, Opioid; Pain, Postoperative; Abdominal Muscles; Abdomen
PubMed: 37624474
DOI: 10.1007/s11916-023-01158-7 -
Seminars in Plastic Surgery Aug 2023Microsurgery has changed the ability to perform highly precise and technical surgeries through the utilization of high-powered microscopes and specialized instruments to... (Review)
Review
Microsurgery has changed the ability to perform highly precise and technical surgeries through the utilization of high-powered microscopes and specialized instruments to manipulate and repair anatomical structures as small as a few millimeters. Since the first human trials of robotic-assisted microsurgery in 2006, the expansion of microsurgery to supermicrosurgery (luminal diameter less than 1 mm) has enabled successful repair of previously inaccessible structures. Surgical robotic systems can offer two distinct operative advantages: (1) minimal access surgery-by entering body cavities through ports, flap harvest can be redesigned to affect a minimally invasive approach for flaps such as the rectus abdominis muscle, the latissimus flap, and the deep inferior epigastric perforator flap; and (2) precision-by eliminating physiologic tremor, improving ergonomics, increasing accessibility to difficult spaces, and providing motion scaling, precision is significantly enhanced. Robotic-assisted microsurgery is a promising application of robotics for the plastic surgeon and has played an important role in flap harvest, head and neck reconstruction, nerve reconstruction, gender-affirming surgery, and lymphatic reconstruction-all the while minimizing surgical morbidity. This article aims to review the history, technology, and application of microsurgery and supermicrosurgery in plastic surgery.
PubMed: 38444959
DOI: 10.1055/s-0043-1771506