China
Africa
Explore chapters and articles related to this topic
Physical Activity for Women
Published in Michelle Tollefson, Nancy Eriksen, Neha Pathak, Improving Women's Health Across the Lifespan, 2021
Ginger Garner, Wendy Farnen Price
Currently, the return to PA is largely left up to personal preference, with no guidelines being given for rehabilitation after childbirth. The American College of Obstetrics and Gynecology (ACOG) recommends that PA should resume as early as medically possible, depending on the mode of delivery and the presence of medical complications;47 however, there are no guidelines that specify different recommendations for women with vaginal delivery that require sutures.53 Australia, UK, and Norway provide similar nonspecific recommendations,53 which include initiating: Pelvic floor exercises in the immediate postpartum period.Abdominal strengthening exercises for addressing diastasis rectus abdominis and improving pelvic floor function.54,55Regular aerobic exercise.PA in lactating women, which can improve maternal cardiovascular fitness without compromise of milk production, composition, or infant growth.56
Lisfranc injuries
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
The suggested order of reduction is the medial, middle and then the lateral column. Anatomical reduction with joint congruity must be achieved. Large intra-articular fractures can be stabilised first prior to joint reduction and then the TMT joint can be stabilised with trans-articular screws or bridging plates. Trans-articular screws can arguably further damage the articular surface. Highly comminuted intra-articular fractures may need to be treated by fusion. Care should be taken to reduce the inter-cuneiform joints also, as it is not uncommon for diastasis to occur at this level. The lateral column can be similarly reduced and stabilised with K-wires, which can be removed later to maintain lateral column mobility.
Bladder exstrophy and epispadias
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Separation of the pubic bones in the midline (referred to as the diastasis) varies considerably. In primary epispadias, where only the urethra is open, the recti and the symphysis may be joined, whereas in the most severe forms of exstrophy the diastasis and separation of the rectus muscles at birth may be >5 cm. The size of the abdominal wall defect and the degree of difficulty in closure of the abdomen is directly related to the extent of the diastasis. The proximal ends of the penile corpora are attached on either side to the inferior pubic rami. While they may be shorter than normal corporal bodies, the separation of the pubic symphysis results in a Y- shaped penis and further limitation of the penile length (Figure 79.3). The urethra in the male is an open plate on the dorsum of the corpora and it has no relation to any sphincter muscles at birth. A normal sphincter complex is present in the perineum, however, which can be shown by direct stimulation in the area of the prostate gland between the proximal penile corporal attachments.
Effects of hypopressive exercises on post-partum abdominal diastasis, trunk circumference, and mechanical properties of abdominopelvic tissues: a case series
Published in Physiotherapy Theory and Practice, 2023
Miriam Ramírez-Jiménez, Francisco Alburquerque-Sendín, Juan Luis Garrido-Castro, Daiana Rodrigues-de-Souza
Abdominal diastasis (AD) is defined as a separation of greater than 2 cm between the rectus abdominis muscles at the linea alba (LA) (Boissonnault, Blaschak, and Blaschak, 1988; Michalska et al., 2018), at any supraumbilical of infraumbilical region during pregnancy and postpartum (Benjamin, van de Water, and Peiris, 2014). The prevalence of AD is between 39% and 45.4% six months after delivery, and 32.6% at 12 months after delivery (Mota, Pascoal, Carita, and Bø, 2015; Sperstad et al., 2016). Moreover, AD has been associated to histological changes of the LA (Blotta et al., 2018), and to an increase of intra-abdominal pressure (Carlstedt et al., 2021). Furthermore, other symptoms and dysfunctions may be associated with AD, such as abdominal and low back pain, a worsened body image perception (Keshwani, Mathur, and McLean, 2018), or loss of abdominal muscle strength (Benjamin et al., 2019; Hills, Graham, and McLean, 2018; Lee, Lee, and McLaughlin, 2008).
Surgical techniques for repair of abdominal rectus diastasis: a scoping review
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Majken Lyhne Jessen, Stina Öberg, Jacob Rosenberg
Rectus diastasis is a condition in which the rectus abdominis muscles are separated by an abnormal distance due to widening of the linea alba. Rectus diastasis can be congenital but is most commonly acquired due to laxity of the linea alba [1]. The main risk factors are pregnancy and obesity leading to the two most common profiles: men with central obesity and small, fit women who carried a large fetus or twins to term [2]. The incidence in pregnancy’s third trimester is as high as 66%, and 30–60% have rectus diastasis postpartum [3,4]. The symptoms and discomforts associated with rectus diastasis are a debated area [2]. Nevertheless, rectus diastasis may be associated with negative body image, musculoskeletal pain, and urogynecological symptoms [5]. The condition is not to be confused with a hernia, as the rectus fascia is intact. There are different treatment options including conservative treatment with physiotherapy, surgical repair, or both [2]. A systematic review stated that physiotherapy was unable to reduce the diastasis in a relaxed state, but some reduction during muscle contraction was described [6]. It seems like the only convincing results with complete normalization of the distance between the rectus muscles is seen after surgical treatment. Various surgical methods are described in the literature. However, an overview of different surgical techniques is lacking.
Physiotherapist management of a patient with spastic perineal syndrome and subsequent constipation: a case report
Published in Physiotherapy Theory and Practice, 2021
Shankar Ganesh, Mritunjay Kumar
The initially prescribed intervention (i.e. puborectalis relaxation exercises) did not provide the intended benefits. A detailed neuromuscular examination was undertaken. There was no history of any red flags such as bleeding from the anus, anemia, weight loss, fever, and presence of blood in the stools. The patient had a symmetrical diaphragmatic type of breathing, and the dynamic thoracic perimeter measurement in an erect upright position at the axillary region, and the xiphoid region showed normal thoracic mobility (3 and 4 cms expansion respectively). Examination showed the absence of diastasis recti and abdominal muscle spasms. The strength of hip abductors (left side) was graded as 4/5 on manual muscle testing and the other muscles were graded 5/5. Perineal examinations showed no gaping in the anus and neurological examination revealed intact perineal sensation and anocutaneous reflex (George and Borello-France, 2017). Palpation showed significant tenderness around the rectal region.