The treatment of diastasis rectus abdominis (DRA) can be complex. Medical clinical centers are often the first line hospitals for the diagnosis and treatment of DRA in postpartum women in China. The standardized rehabilitation designed by us can effectively alleviate DRA of the postpartum women (Table 2,3,4,5). Simultaneously, the results may also help medical staff and rehabilitation physiotherapists who are engaged in postpartum rehabilitation in other clinical hospitals, assist in alleviating the symptoms of DRA patients, and improving the quality of life.
DRA is one of the common complications during pregnancy and postpartum. It can appear around 14 weeks of pregnancy and gradually worsens until delivery. In the past, little attention was paid to maternal postpartum DRA. However, with more and more research and studies, people have a deeper understanding of DRA, which has become clearer, although diagnosis and treatment of DRA are still controversial[7, 18]. However, it has been clearly reported that long-term postpartum DRA will lead to health complications, such as persistent low back pain, abdominal and pelvic pain, and so on. According to statistics, approximately 40% of women report persistent lower back and pelvic pain in the first half-year after childbirth[17, 19]. For many postpartum women, DRA is not a health problem that can be solved by itself, and may even progress for many years. Therefore, whether to intervene or treat is the key related to whether the symptoms of DRA can be relieved directly or indirectly, and this is essential for improving the quality of life of postpartum women.
Previously, surgery is an effective treatment for DRA. While depending on the understanding of DRA, non-surgical treatment and/or early active intervention methods are another effective way to treat DRA. Simultaneously, parturients regular abdominal exercises and aerobic exports, pelvic floor muscle exercise, posture and back care, corsets, acupuncture treatment and other methods are all recommended as efficient non-surgical interventions for the treatment of DRA[2, 7, 10]. Previous study have proven that abdominal muscle exercise has been proven to be very effective in reducing DRA in the early postpartum period, which means exercise can significantly improve the symptoms of DRA and is an effective non-surgical solution. To date, there is little scientific knowledge about which non-surgical methods are recommended to treat DRA, and there is a lack of regulation and standardization as well, although there are many recommended non-surgical methods. Here, we have set this standardized rehabilitation procedure (Suppl. Figure 1-19) and treated the patients since 2017 obtained effective results as presented above. All the parturients who received standardized rehabilitation treatment have been significantly improved, and the quality of life has been significantly improved.
In China, Chinese traditional acupuncture physiotherapy is efficient and has its own characteristics, but it is very difficult to master. Using this method to treat DRA patients is time-consuming and laborious. Exercise pelvic floor muscles, rectus abdominis, and other exercise programs are mainly subjective recovery treatment methods, which require patients to fully complete exercise and perseverance. Other studies have reported that electrophysiological and magnetic therapy equipment can effectively relieve DRA in postpartum women. Based on the understanding of the previous research, combined with the characteristics of electrophysiological treatment, we have designed the current standardized rehabilitation treatment program for DRA. Through clinical trials and promotion in recent years, good effects have been achieved, which suggested that standardized rehabilitation treatment is safe and efficacy to parturients with DRA. The standardized rehabilitation treatment model we set is mainly the standardized operation of medical staff or rehabilitation physiotherapists and the proficient use of electrophysiological treatment equipment. The whole course of treatment has a short cycle (20 days) and remarkable curative effect while giving patients a comfortable treatment environment. Compared with other non-surgical treatments for DRA, we found after standardized rehabilitation treatment that the separation of the rectus abdominis above the umbilical cord, below the umbilical cord, and the central part of the umbilicus of the parturients' DRA were significantly improved, not partial recovery.
As what we know, the non-surgical treatment used for DRA is somewhat different from the standardized rehabilitation treatment we designed. The current research plan adopts a combination of Chinese and Western medicine, but not complicated, which is more convenient to master, apply and promote. The significance of our research is to treat patients with DRA through a reasonable, simple, and effective standardized method, so that patients can benefit. At the same time, this technology can also be shared with other medical staff or rehabilitation physiotherapists to help more patients. Indeed, we hope to promote this standardized rehabilitation treatment and obtain further improvements and enhancements as well.