A Randomized Controlled Trial to Evaluate the Effect of Abdominal Electrical Muscle Stimulation on Abdominal Wall Restoration in Postpartum Women

Abstract

Background: Diastasis of recti abdominis muscle (DRAM) is a common condition occurring postpartum and thought to be a cause for back pain and pelvic instability. Electrical muscle stimulation (EMS) had been used in abdominal muscle rehabilitation in combination with exercises in DRAM. This study looks at the effect of EMS in treating DRAM in comparison to a control group receiving no treatment.

Methods: This is a prospective randomized clinical trial. A total of 51 patients were included in the study, including group A (28 patients) that was treated with EMS, and a control group B (23 patients) that did not receive any treatment. Pre-treatment baseline, 1-, 3-, and 6-month follow-up data were collected. Results were evaluated through ultrasound measurements of inter-rectal distance (IRD), investigator assessments, patient subjective improvement and satisfaction and Pelvic Floor Distress Inventory (PFDI) questionnaire.

Results: Ultrasound IRD measurements demonstrated improvement from baseline to the 3-month and 6-month follow-up in the treatment group. Investigator assessment favored the treatment group with significant difference at all study points. Subjective assessments by patients demonstrated a significant difference between the two groups at 1-month while continued to show improvement at 3- and 6-months follow-up. PFDI questionnaire favored the treatment group over the control group in three PFDI subscales at all study points. Progress of the EMS effect over time was shown.

Conclusions: The current study supports potential efficacy of the EMS device as a stand- alone treatment modality for the improvement of DRAM in postpartum women.

J Clin Gynecol Obstet. 2021;10(3):59-66
doi: https://doi.org/10.14740/jcgo755