Table 1.
Studies included in the qualitative synthesis.
| Author | Year | Study type | No. of patients | Main finding |
|---|---|---|---|---|
| Effect of physiotherapy | ||||
| Mota et al. 28 | 2015 | Longitudinal cohort study | 84 | Abdominal Crunch Exercise produced significant narrowing of the IRD |
| Gluppe et al. 29 | 2018 | RCT | 175 | No significant effect on IRD of a postpartum training program |
| Thabet et al. 12 | 2019 | RCT | 40 | A deep core stabilizing program reduces inter-recti distance (IRD) in postpartum women with DRAM |
| Emanuelsson et al. 9 | 2016 | RCT | 32 | Improved muscular strength, function, and quality of life after a 3 months training program in patients with DRAM |
| Width of the diastasis | ||||
| Mota et al. 18 | 2018 | Prospective cohort study | 84 | Definition of normal IRD during pregnancy and 6 months postpartum |
| Ranney 4 | 1990 | Cross-sectional descriptive study | 1763 | Classification of DRAM. High prevalence of umbilical hernias in women with DRAM. |
| Liaw et al. 20 | 2011 | Prospective cohort study | 40 + 20 controls | No clear relationships found between width of diastasis and abdominal muscle function in postpartum women. |
| Gunnarsson et al. 21 | 2015 | Cross-sectional descriptive study | 57 | A positive correlation existed between abdominal muscle strength and IRD below the umbilicus, but not when IRD was measured above the umbilicus. |
| Kohler et al. 30 | 2018 | Case series | 20 | Concomitant repair of ventral hernias and DRAM |
| Olsson et al. 5 | 2019 | Prospective cohort study | 60 | 75% of women operated for DRAM had concomitant ventral hernias |
| Preoperative diagnostic imaging | ||||
| Mota et al. 24 | 2012 | Test–retest reliability study | 24 | Ultrasound imaging is a reliable method for measuring the IRD |
| Keshwani et al. 23 | 2018 | Cross-sectional study | 32 | Ultrasound measurement of IRD in the early postpartum period correlated well to symptoms of DRAM. |
| Emanuelsson et al. 31 | 2014 | Cross-sectional study | 55 | Clinical assessment prior to surgery provides more accurate information than CT scanning in the assessment of ARD width. |
| Time between last childbirth and operation | ||||
| Boissonnault et al. 25 | 1988 | Cross-sectional study | 71 | DRAM most common in third trimester and persists in the immediate postpartum period. |
| Sperstad et al. 26 | 2016 | Prospective cohort study | 300 | Prevalence of DRAM was 33% 12 months after delivery. |
| Ranney 4 | 1990 | Cross-sectional study | 1738 | Less than 1% of parous women had a “severe” diastasis exceeding 5 cm. |
| Surgical methods | ||||
| Van Uchelen et al. 32 | 2001 | Cross-sectional study | 40 | 40% recurrence rate after repair of DRAM as part of abdominoplasty. |
| Bellido Luque et al. 33 | 2015 | Prospective cohort study | 21 | No recurrence after totally endoscopic approach to diastasis recti associated with midline hernias (no mesh) |
| Köhler et al. 30 | 2018 | Prospective cohort study | 20 | No recurrence at 5 months after minimal invasive linea alba reconstruction (MILAR) |
| Köckerling et al. 34 | 2016 | Prospective cohort study | 40 | No early recurrences after endoscopic-assisted linea alba reconstruction plus mesh augmentation (ELAR plus) |
| Emanuelsson et al. 9 | 2016 | RCT | 86 | No difference in outcome between retromuscular mesh repair and double-row self-retaining sutures. |
| Nahas et al. 35 | 2005 | Case series | 12 | No recurrence rate 6–7 years after plication of DRAM. |
| Olsson et al. 5 | 2019 | Prospective cohort study | 60 | Significant improvement in quality of life and abdominal trunk function after surgical repair of DRAM. |
IRD: inter-recti distance; RCT: randomized controlled trials; DRAM: diastasis of the rectus abdominis muscle; ARD: abdominal rectus diastasis; MILAR: minimal invasive linea alba reconstruction; ELAR: endoscopic-assisted linea alba reconstruction plus mesh augmentation.