Effects of Tupler's Technique on Postpartum Diastasis Recti and Strength Recovery of Abdominal Muscles
Condition: Diastasis Recti
MeSH terms: Diastasis, Muscle
Study type: Interventional

Summary: 
      Diastasis rectus is the separation of the muscles along the midline of the abdomen, typically
      as seen in women after pregnancy. Separation is mostly larger than 2cm width at above, below
      or level of umbilicus. With this muscular pathology women do not feel any pain symptom just
      perceiving symptoms of physical discomfort, abdomen muscle weakness and its bulging. Excess
      weight of mother or baby and multiple birth pregnancy is the common risk factor for the DRA.
      Various tools will be used for the diagnosis of DRA such as vernier caliper by using
      centimeter ruler, diagnostic ultrasonography that give the exact measurement, pressure
      biofeedback unit which is used to assess the strength of weak muscles, and patient specific
      functional scale that used to determine the functional limitation and its improvement.

      To treat the DRA conservatively, Tupler's technique and conventional physical therapy will be
      directed. Electrical muscular stimulations will also be given as a baseline before applying
      both treatments. In Tupler's technique, diastasis rehab splint and Tupler's exercises will be
      used whereas in conservative physical therapy, scarf tie around abdomen while performing
      exercises, Respiratory rehabilitation manoeuvre and abdominal muscle exercises will be used.
      The aim of the study is to find the the effects of Tupler's technique and conventional
      physical therapy treatment for abdominal muscle strength regaining and in reducing the
      diastasis recti among females with diastasis recti after their postpartum period. It is a
      Randomized clinical trial and convenient random sampling is to be used with an inclusion
      criterion of patients having age between 20-40 years, Both primiparous and multiparous women
      and Diastasis recti more than 2.5cm within 6 weeks or more postpartum. Patients will be
      randomly allocated into two groups, Group A will receive Tupler's technique and Group B will
      receive conventional physical therapy intervention. Total duration of study will be six
      months. Assessment will be done before and after the treatment. Pressure biofeedback unit,
      vernier caliper, ultrasound and patient specific functional scale are to be used to measure
      the outcomes. Data will be assessed by using parametric/non parametric test after completion
      of study.
    


Intervention name(s): Tupler technique; conventional therapy
Intervention type(s): Other; Other
Intervention description(s): The subjects with DRA will receive Tupler's technique treatment plan for 18 weeks in which four steps will be followed.
Repositioning with diastasis rehab splint :
Protect the connective tissue
Tupler's technique exercises (elevators, contractions, standing pelvic tilt, head lifts, leg slides, low back stretch) with 10 repetitions for each exercise.
Diastasis safe exercises program to maintain the gains; The subjects with DRA will receive conventional physical therapy treatment for 16 weeks in which researcher will follow these steps:
Tie a scarf around abdomen while performing exercises
Exercise program for diastasis recti abdominal muscles; sit ups, reverse sit ups, reverse trunk twist and U-seat exercises. (10 repetitions for each exercise)
Respiratory rehabilitation manoeuvre
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment