Comparison of Hypopressive Breathing and Noble Technique on DRA in Postpartum Women.

Study Overview
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Brief Summary
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The aim of study is to compare the effect of Hypopressive breathing and noble technique on width of Diastasis Recti Abdominis, lumbopelvic pain and maternal functioning in postpartum women.

Detailed Description
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Candido shows that Caesarean section increased the likelihood of experiencing an increase in the inter-rectus distance during the postpartum period. Diastasis recti abdominis (DRA) is a common condition in postpartum women that can cause abdominal muscle separation. However, there is a lack of direct comparison between these two techniques. This study aims to compare the effectiveness of the hypopressive breathing and the Noble Technique in improving DRA in postpartum women.

Official Title
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Comparison of Hypopressive Breathing and Noble Technique on Diastasis Recti Abdominis in Postpartum Women.

Conditions
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Diastasis Recti Abdominis

Intervention / Treatment
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* Other: hypopressive breathing
* Other: noble technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Multiparous women History of Cesarean section and vaginal delivery > 12 weeks postpartum Measurement is 2cm or more then 2cm of DRA is included by using finger width palpation and Nylon digital caliper Lumbopelvic pain (NPRS 3 to 8) Exclusion Criteria: Exclude women who need surgical correction for DRA Pelvic organ prolapse Para umbilical hernia Malignancy Bone tuberculosis Fibromyalgia

Ages Eligible for Study
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Minimum Age: 24 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: hypopressive breathing technique<br>These exercises involved sucking in the abdomen and opening the ribs by engaging the accessory inspiratory muscles, such as the serratus anterior, external intercostalis, scalenes, and sternocleidomastoid, while maintaining the glottis closed, a process known as diaphragmatic suction. | Other: hypopressive breathing<br>* Hot pack for 10min.Hypopressive breathing in sitting, lying and standing position. Hypopressive breathing 2 times/weekly, 5sec hold, 2-3reps, 1-2sets for 12 weeks. Session will be weekly progress.<br>|
| Experimental: noble technique<br>The Noble technique is (partially sitting up while manually flexing the rectus Abdominis muscles. | Other: noble technique<br>* Hot pack for 10min. Noble technique in relaxed supine position 2time/weekly, 3-5sec hold, 10-15reps, 2-3sets for 12 weeks. Session will be weekly progress.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified OSWESTRY Low Back pain Index (ODI) | The Oswestry Low Back Pain Disability Index is a 10-point patient-reported outcome questionnaire that was first published in 1980. It is regarded as the gold standard for assessing quality of life (QoL) impairment and disability in persons with low back pain | 12 weeks | 
| IFSAC (Inventory of Functional Status After Childbirth) | The IFSAC consists of five subscales and 36 items, that is, infant care (6 items), personal care (8items), household activities (12 items), social and community activities (6 items), and occupational activities (4 items). The questionnaires are rated on a 4-point Likert scale and mean scores were calculated with one point being the lowest and four points being the highest scores possible. | 12 weeks | 
| Numeric Pain Rating Scale (NPRS): | The numeric pain rating scale (NPRS), a scoring system that quantifies pain on a scale from 0 (no pain) to 10 (worst possible agony), was used to determine the pain score. | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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hypopressive, noble technique, DRA, postpartum women