پاسخ ساختاری عضلات شکمی به شش هفته تمرین تقویتی در زنان مبتلا به دیاستازیس رکتی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 دانشیار گروه فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استاد گروه علوم پایه، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: به فاصله گرفتن دو بخش عضله راست شکمی بیش از 2 تا 7/2 سانتی‌متر، دیاستازیس رکتی گفته می‌شود که می‌تواند فعالیت‌های شکمی مانند تنفس، ادرار کردن و زایمان را تحت تأثیر قرار دهد و ممکن است وضعیت بدنی را تغییر دهد و ناحیه کمری لگنی را مستعد آسیب نماید. با توجه به اهمیت تمرین درمانی در درمان دیاستازیس رکتی، مطالعه حاضر با هدف بررسی تأثیر تمرینات تقویتی عضلات مایل شکم بر فاصله دو عضله راست شکمی و ضخامت عضلات شکمی در زنان مبتلا به دیاستازیس رکتی انجام گرفت.
روش‌کار: این مطالعه کارآزمایی بالینی تصادفی شده دارای گروه کنترل‌ در پاییز و زمستان سال 1396 بر روی 32 نفر از زنانی که 6 ماه از زایمانشان گذشته و مبتلا به دیاستازیس رکتی بوده و به درمانگاه فیزیوتراپی حضرت زینب شهرستان نور ارجاع داده ‌شده بودند، انجام شد. فاصله دو بالک عضله راست شکمی و ضخامت عضلات شکم در حالت استراحت قبل از مداخله توسط سونوگرافی تعیین شد. در گروه مداخله، تمرین تقویتی عضلات مایل به مدت 6 هفته در منزل انجام گرفت. گروه کنترل تمرین خاصی انجام نداد. بعد از 6 هفته مجدداً سونوگرافی برای تعیین فاصله دو بالک عضله راست شکمی و ضخامت عضلات شکم در وضعیت استراحت انجام گرفت. تجزیه ‌و تحلیل داده‌ها با استفاده از نرم‌افزار آماری  SPSS(نسخه 22) و آزمون‌های تی تست، من‌ویتنی، پیرد تی تست و ویلکاکسون انجام شد. میزان pکمتر یا مساوی 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: فاصله دو بالک عضله راست شکمی بعد از 6 هفته تمرین در گروه مداخله کاهش معناداری نشان داد (بالای ناف 001/0=p، پایین ناف 03/0=p). ضخامت عضلات مایل داخلی و خارجی و عضلات عرضی شکمی دوطرف بعد از 6 هفته در گروه مداخله افزایش معناداری داشت (05/0p<). در گروه کنترل فاصله دو بالک عضله راست شکمی و ضخامت عضلات شکمی تغییر معنی‌داری نداشت.
نتیجه‌گیری: تمرینات تقویتی عضلات مایل شکم فاصله دو بالک عضله راست شکمی را کاهش داده و ضخامت عضلات مایل و عضلات عرضی شکم را در زنان مبتلا به دیاستاز رکتی افزایش می­دهد.

کلیدواژه‌ها

عنوان مقاله [English]

Structural response of abdominal muscles to six weeks of strengthening training in women with diastasis recti

نویسندگان [English]

  • Fatemeh Izadi 1
  • Minoo Khalkhali Zaviyeh 2
  • Alireza Akbarzadeh Baghban 3
1 M.Sc. student of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Assistant professor, Department of Physiotherapy, School of Rehabilitation, Shahid Behshti University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Basic Sciences, School of Rehabilitation, Shahid Behshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Diastasis recti is defined as separation of the two bellies of the rectus abdominis muscles more than 2 to 2.7 cm which could affect the abdominal activities such as breathing, urination and delivery, and may change the body posture and 
make the lumbar and sacral regions susceptible to injury.  Regarding the importance of therapeutic exercises in treatment of diastasis recti, this study was performed with aim to investigate the effect of strengthening training of oblique muscles on inter-recti distance and thickness of abdominal muscles in women with diastasis recti.
Methods: This randomized controlled clinical trial was performed on 32 women with diastasis recti and at least six months since delivery who referred to physiotherapy center of Hazrate Zainab clinic of Noor city in 2017. The inter recti distance and the thickness of the abdominal muscles before the intervention was determined by ultrasound at rest. In the intervention group, strengthening training of oblique muscles was conducted at home for six weeks .The control group did not do any specific exercises. After six weeks, the inter recti distance and abdominal muscle thickness were measured again using ultrasound at rest. Data was analyzed by SPSS software (version 22) and t-test, Mann-Whitney, Paired t test, and Wilcoxon test.
Results: The inter recti distance after six weeks of training in the intervention group showed a significant decrease (p=0.001 and p=0.03 in upper and lower umbilicus). The thickness of the oblique muscles and the transverse abdominal muscles in both side was significantly increased after six weeks in the intervention group (p<0.05). In the control group, there was no significant change in the inter recti distance and the thickness of the abdominal muscles.
Conclusion: Strengthening training of oblique muscles reduces inter-recti distance and increase the thickness of the oblique muscles as well as the transverse abdominal muscles in women with diastasis recti.

کلیدواژه‌ها [English]

  • Diastasis recti
  • Muscle thickness
  • Oblique abdominal muscles
  • Strengthening training

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مجله زنان، مامایی و نازایی ایران
دوره 21، شماره 9
آذر 1397
صفحه 71-82

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