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Diastasis RectiNCT07642141

Combined Effects of Hypopressive Exercises and Abdominal Bracing on Diastasis Recti Outcomes

A study testing Hypopressive exercise and Abdominal Bracing and Hypopressive Exercise in people with Diastasis Recti, run by Riphah International University at 1 site in Pakistan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Diastasis Recti Abdominis (DRA) is the separation of the rectus abdominis muscles along the linea alba, commonly seen after childbirth due to the mechanical and hormonal changes that occur during pregnancy. Read more about this study

Who is it for?
Ages 23 to 30 years, women only
Conditions the study is for
Diastasis Recti
What is being tested?
Hypopressive exercise and Abdominal Bracing and Hypopressive Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
34 participants
Where
1 sitePakistan
Study dates
2 Apr 2025to 15 Aug 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 23 to 30 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age group of 23 to 30 years
  • Inter recti distance > 2 to 5 cm
  • A women who had undergone a vaginal delivery at least 8 weeks before the first measurement
  • A postpartum female with the presence of diastasis rectus abdominis
  • BMI under or equal to 29kg/m2

Who cannot join

  • Pregnant females (29)
  • Subjects who underwent any recent abdominal surgeries
  • Patient diagnosed with a Fibroid uterus
  • Patient diagnosed with abdominal hernia
  • Cesarean section (C-section)
  • Chronic medical conditions such as diabetes, uncontrolled hypertension, cardiovascular disease, or thyroid disorders.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Imran Amjad, PHD* contact

03324390125

imran.amjad@riphah.edu.pk

Imran Amjad, PHD* contact

0515481826

imran.amjad@riphah.edu.pk

Pakistan1 site, 1 recruiting
  • Jinnah Hospital

    Lahore, Punjab Province, 54000

    Ghulam Fatima, PhD*, 03034073057, ghulam.fatima@riphah.edu.pk

    Recruiting

Other trials in Pakistan

About this study

Official title: Combined Effects of Hypopressive Exercises and Abdominal Bracing on Interrecti Distance, Lumbopelvic Pain, and Abdominal Muscle Strength in Diastasis Recti

Diastasis Recti Abdominis (DRA) is the separation of the rectus abdominis muscles along the linea alba, commonly seen after childbirth due to the mechanical and hormonal changes that occur during pregnancy. DRA can negatively affect posture, trunk stability, and breathing patterns, and may result in persistent lumbopelvic pain and weakened core muscles if not properly managed. Although hypopressive exercises and abdominal bracing have individually demonstrated positive effects in reducing inter-recti distance and improving core function, limited research exists regarding their combined effects. This randomized clinical trial aims to evaluate the combined impact of hypopressive exercises and abdominal bracing on inter-recti distance, lumbopelvic pain, and abdominal muscle strength in postpartum women with DRA. The study will include 34 postpartum women recruited from Jinnah Hospital, Lahore, who will be randomly assigned into two groups. Group A will receive both hypopressive exercises and abdominal bracing, while Group B will receive only hypopressive exercises along with standard postpartum physiotherapy. Outcome measures will include pain intensity, lumbopelvic disability, abdominal muscle strength, and inter-recti distance, with data analyzed using SPSS version 25.

Read the detailed description

Diastasis Recti Abdominis (DRA) is the separation of rectus abdominis muscles along the linea alba, which is common after childbirth due to the mechanical and hormonal changes that occur during pregnancy. DRA can affect posture, trunk stability, and breathing patterns, and may lead to persistent lumbopelvic pain and a weakened core if not managed properly. Although hypopressive exercises and abdominal bracing have individually shown promising results in reducing interrecti distance and improving core function, limited research is available on their combined effects. This study aims to evaluate the combined impact of hypopressive exercises and abdominal bracing on inter-recti distance, lumbopelvic pain, and abdominal muscle strength in postpartum women with DRA.

This study will be a randomized clinical trial. The study will be conducted at Jinnah Hospital, Lahore, over 10 months, involving a total of 34 postpartum women selected through non-probability convenience sampling. Participants will be randomly assigned to two groups: Group A will receive a combination of hypopressive exercises and abdominal bracing, and Group B will receive only hypopressive exercises. The hypopressive protocol includes diaphragmatic breathing cycles followed by rib cage expansion and a 10-second apnea, while the abdominal brace will be worn during waking hours for six weeks, except during bathing and exercising. Both groups will also receive standard postpartum physiotherapy. Outcome measures include the Numerical Pain Rating Scale (NPRS) to evaluate pain intensity, the Pelvic Girdle Questionnaire (PGQ) to assess lumbopelvic disability, Manual Muscle Testing (MMT) for abdominal muscle recti distance. Data will be analyzed using SPSS version 25, and with p-value of <0.05 will be considered statistically significant.

Conditions
Diastasis Recti
Being tested
Hypopressive exercise and Abdominal Bracing, Hypopressive Exercise
Keywords
Lumbopelvic pain, Hypopresive Exercise, Abdominal Bracing

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hypopressive exercise and Abdominal BracingOther

    The hypopressive exercise protocol included maintaining spinal elongation, a neutral pelvis, knee flexion, and scapular muscle activation. Participants performed diaphragmatic breathing followed by full expiration and a 10-second apnea with rib cage expansion, causing inward abdominal contraction without inhalation. Exercises were performed in lying, sitting, standing, kneeling, and four-point kneeling positions. Each exercise was repeated three times with 30-second rest intervals. The intervention lasted 6 weeks with 12 sessions.

    Participants in Group A also used an ITA-Med postnatal abdominal binder made of breathable elastic material. The binder covered the area from the pubis to the lower ribs and was worn during waking hours for 6 weeks, except during sleep and bathing. It was applied while lying down and adjusted for a snug but comfortable fit. Participants were instructed to avoid excessive tightness and monitor the skin for irritation.

  • Hypopressive ExerciseOther

    Each exercise was performed during the expiratory phase and required the contraction of the pelvic floor muscles. Participants were instructed to perform between 1 to 3 sets of 10 repetitions per exercise, holding each contraction for 5 seconds followed by 10 seconds of relaxation. The number of sets and the difficult level were progressively adjusted over time. This treatment protocol will be performed over a time period of 6 weeks

Study groups in NCT07642141
Study groupRoleWhat they receive
Group A: Hypopressive Exercise and Abdominal BracingExperimentalThe hypopressive exercise protocol included maintaining spinal elongation, a neutral pelvis, knee flexion, and scapular muscle activation. Participants performed diaphragmatic breathing followed by full expiration and a 10-second apnea with rib cage expansion, causing inward abdominal contraction without inhalation. Exercises were performed in lying, sitting, standing, kneeling, and four-point kneeling positions. Each exercise was repeated three times with 30-second rest intervals. The intervention lasted 6 weeks with 12 sessions. Participants in Group A also used an ITA-Med postnatal abdominal binder made of breathable elastic material. The binder covered the area from the pubis to the lower ribs and was worn during waking hours for 6 weeks, except during sleep and bathing. It was applied while lying down and adjusted for a snug but comfortable fit. Participants were instructed to avoid excessive tightness and monitor the skin for irritation.
Receives: Other: Hypopressive exercise and Abdominal Bracing
Group B: Hypopressive Exercise onlyActive comparatorEach exercise was performed during the expiratory phase and required the contraction of the pelvic floor muscles. Participants were instructed to perform between 1 to 3 sets of 10 repetitions per exercise, holding each contraction for 5 seconds followed by 10 seconds of relaxation. The number of sets and the difficult level were progressively adjusted over time.
Receives: Other: Hypopressive Exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Numerical Pain Rating Scale (NPRS)

    It is a standardized self-reporting scale consisting of a horizontal line used to estimate the subjective level of pain intensity. It is a 11 point numerical scale, corresponding to the degree of pain. 0= no pain, 1-2-3 = mild pain, 4-5-6 = moderate pain, 7-8-9-10 = severe pain. The patients will be asked to select from that 11 points numerical continuum the number that corresponds to their perceived pain intensity. NPRS is considered a valid and reliable scale for measures of pain intensity. NPRS has shown high test-retest (r=0.96 and 0.95 ) reliability.

    Measured: 6 weeks

  2. Pelvic Girdle Questionnaire (PGQ)

    It is a straightforward tool with 25 items, 20 of which measure activity restrictions (the activity subscale) and 5 of which measure symptoms (the symptom subscale). Every item is worth four points and is graded on a Likert scale with a range of 0 to 3. The PGQ has a maximum possible score of 75, which includes 15 for the symptom subscale and 60 for the activity subscale. Three points are deducted from the maximum possible score for an item that has no response or a response of "not applicable." The final figures are displayed as a percentage, with 0 denoting no disability and 100 denoting severe disability. A worse result is indicated by a higher score. PGQ is considered a valid and reliable scale for measuring disability. PGQ has shown test-retest reliability ( 0.93 (activity), .91 (symptom).

    Measured: 6 weeks

  3. Manual muscle testing (MMT)

    Manual muscle testing (MMT) is a widely used clinical method for assessing muscle strength by applying manual resistance to specific muscles or muscle groups and grading the response on a standardized 0-5 scale. It is considered a valid and reliable tool, particularly effective in detecting moderate to severe muscle weakness. Studies report high inter-rater reliability (ICC = 0.85-0.98) and good intra-rater consistency when performed by trained clinicians, especially for muscle grades 3 and above.

    Measured: 6 weeks

  4. Tape measure and Finger-Width Method

    The finger-width method and tape measure are commonly used clinical tools to assess diastasis recti postpartum. The finger-width method shows good intra-rater reliability (Kappa > 0.7) but only moderate inter-rater reliability (Kappa ≈ 0.53) and limited validity compared to ultrasound. In contrast, the tape measure method demonstrates excellent intra- and inter-rater reliability (ICC = 0.80-1.00) and strong validity, with high correlation to ultrasound (r = 0.82-0.98). While ultrasound remains the 14 gold standard, the tape measure is a more accurate and reliable clinical alternative than the finger-width method.

    Measured: 6 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2026
  2. Study start2 Apr 2025
  3. Primary completion2 Jul 2026 (estimated)
  4. Study completion15 Aug 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
34 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07642141
Sponsor's protocol ID
REC/RCR & AHS/25/0525
Status last verified
Jun 2026
First submitted
8 Jun 2026
Last updated
11 Jun 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Hsia M, Jones S. Natural resolution of rectus abdominis diastasis. Two single case studies. Aust J Physiother. 2000;46(4):301-307. doi: 10.1016/s0004-9514(14)60291-9.

    PubMed 11676815
  • Mota P, Gil Pascoal A, Bo K. Diastasis recti abdominis in pregnancy and postpartum period. Risk factors, functional implications and resolution. Current women's health reviews. 2015;11(1):59-67

  • Michalska A, Rokita W, Wolder D, Pogorzelska J, Kaczmarczyk K. Diastasis recti abdominis - a review of treatment methods. Ginekol Pol. 2018;89(2):97-101. doi: 10.5603/GP.a2018.0016.

    PubMed 29512814
  • Thabet AA, Alshehri MA. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial. J Musculoskelet Neuronal Interact. 2019 Mar 1;19(1):62-68.

    PubMed 30839304

Questions about this trial

What is this clinical trial studying?

A study testing Hypopressive exercise and Abdominal Bracing and Hypopressive Exercise in people with Diastasis Recti, run by Riphah International University at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 11 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Imran Amjad, PHD* (03324390125, imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Numerical Pain Rating Scale (NPRS) (time frame: 6 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07642141, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jun 2026.

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