Evidence map›Paper›PMID 41224804›Full record

SynthesisScientific reports2025

An evidence-based comparison of rehabilitation strategies for diastasis recti abdominis in postpartum women: a systematic review and network meta-analysis.

Nahid Bigdeli, Ali Yalfani, Amin Doosti-Irani, Ali Qodrati

Abstract readSystematic ReviewComparative StudyNetwork Meta-Analysis
In one paragraph

Synthesis in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Nahid BigdeliDepartment of Exercise Rehabilitation, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran. n.bigdeli@phe.basu.ac.ir.ORCID http://orcid.org/0000-0003-3696-7208
Ali YalfaniDepartment of Exercise Rehabilitation, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran. yalfani@basu.ac.ir.ORCID http://orcid.org/0000-0002-2721-6085
Amin Doosti-IraniDepartment of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.ORCID http://orcid.org/0000-0003-0623-7503
Ali QodratiDepartment of Sport Management, Shahid Beheshti University, Tehran, Iran.ORCID http://orcid.org/0009-0003-8687-8470

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study aimed to compare the effectiveness of various physical therapy interventions, including exercise and non-exercise-based approaches, for improving intera recti distance (IRD) in women with postpartum diastasis recti abdominis (DRA). A systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) was conducted following PRISMA-NMA guidelines. Databases searched included PubMed, Scopus, ISI Web of Science, Cochrane Library Databases, and manual searches were systematically searched from their inception until October 2024. A total of 27 RCTs involving 1340 postpartum women with DRA and 39 interventions were included. IRD was assessed via ultrasonography or calipers. Treatment effects on IRD were analysed using mean differences (MDs), 95% confidence intervals (CIs), and minimal clinically important differences (MCID) thresholds to determine clinical relevance. All networks revealed low heterogeneity and non-significant inconsistency (I2 = 26.80%). Combined deep and superficial abdominal muscle training versus no-treatment group was associated with a greater reduction in IRD compared to single-muscle approaches and non-exercise modalities, like TCMEB + KT(MD = -26.25, 95% CI = -29.41; -23.09, SUCRA = 0.96), TCME + BPFM + NMES (MD = -25.94, 95% CI = -32.33; -19.54, SUCRA = 0.95), NMES + TCME + MMT (MD = -24.62, 95% CI = -29.78; -19.47, SUCRA = 0.92) and NMES + TCME ( MD = -22.62, 95% CI = -26.58; -18.67, SUCRA = 0.88). The kinesio-taping (MD = -3.93, 95% CI = -6.20; -1.65, SUCRA = 0.18) and abdominal binders (MD = -10.32, 95% CI = -13.81; -6.83, SUCRA = 0.52) demonstrated moderate to low effectiveness. The overall quality of the evidence varied from low to High according to the GRADE approach. No serious publication bias was identified. Based on the findings of this study, comprehensive exercise programs that engage both superficial and deep abdominal muscles, especially when combined with neuromuscular electrical stimulation and breathing techniques, appear more effective than passive or isolated approaches in reducing inter-recti distance in postpartum women. Nevertheless, given the limited direct comparisons and low certainty in some evidence, clinical interpretation should remain cautious. Further well-designed studies with robust controls and direct comparison are needed to confirm and strengthen these findings. Registration: PROSPERO CRD42024593155.

Indexed as

Diastasis, MusclePostpartum PeriodRectus AbdominisExercise TherapyFemaleHumansPhysical Therapy ModalitiesPregnancyRandomized Controlled Trials as TopicAbdominal MusclesExercise therapyInter-recti distanceNetwork meta-analysisPostpartum rehabilitationSystematic review

Identifiers

PMID41224804
PMCPMC12612259

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.