EFFECT OF THE LOW PRESSURE FITNESS (LPF) TECHNIQUE ON DIASTASIS OF THE RECTO ABDOMINAL IN POSTPARTUM WOMEN: RANDOMIZED CLINICAL TRIAL
Rectus Abdominis; Diastasis, Muscle; Postpartum Period
Introduction: Diastasis Rectus Abdominal Muscle (DMRA) is an excessive separation between the bellies of the rectus abdominis muscles. Persistent DRAM, in addition to being an aesthetic concern, has negative effects that are manifested in functionality, trunk resistance and impaired quality of life in postpartum women. Abdominal exercise is generally recommended as an important physical therapy intervention for women with DMRA, and an alternative treatment is the Low Pressure Fitness (LPF) technique. Objectives: To evaluate the effects of LPF on rectus abdominis diastasis in postpartum women; and to evaluate the effects of LPF on pain, functionality, quality of life, perception of the global effect, patient expectation, body image and trunk resistance, in women with DMRA in the postpartum period. Methods: It will be a randomized controlled clinical trial type study, which will follow the CONSORT and TIDieR guidelines and will be carried out at the Clínica Escola de Fisioterapia da FACISA/UFRN, from August to December 2023. Women with DMRA, with 6 to 12 weeks postpartum, and with a palpable separation of the rectus abdominis muscles ≥2 fingers wide. After granting consent to participate in the study, the women will be randomly allocated into two groups: control (GC=53, kinesiotherapy) and experimental (EG=53, Hypopressive Exercises/LPF). All participants, after the first assessment, will undergo an 8-week intervention and will receive a second assessment after the intervention period. During 8 weeks of intervention, both groups will be submitted to treatment programs twice a week, in person, and each session will last from 30 to 45 min. The CG will do a set of kinesiotherapeutic exercises composed of: abdominal crunch, posterior pelvic tilt, kegels and Russian twist, and the EG will perform LPF method exercises with variation of postures associated with a hypopressive maneuver. After applying the protocol, all volunteers will be reassessed. The SPSS® program (version 21.0) will be used to analyze the data. The bootstrapping technique will be used to adapt the quantitative variables to the assumption of parametric distribution. To verify the effects of the interventions and compare the outcome variables, the Analysis of Variance (ANOVA) will be used. Measures with a 95% confidence interval (95%CI) will be presented, the F statistics, the effect size, η2 (eta squared) and the significance level, adopting P<0.05. Expected results: It is expected that the results of this study can provide new knowledge about the LPF Method and how it can act in the treatment of abdominal diastasis in postpartum women and that the protocol of this research can be used in new studies in order to analyze its effectiveness on DMRA.