Effect of Core Stability Exercise in Preventing Diastasis Recti Abdominis among Normal Birth Delivery of Postpartum Mothers: Meta-Analysis


  • Feny Oktaviyani Masters Program in Public Health, Universitas Sebelas Maret
  • Eti Poncorini Pamungkasari Faculty of Medicine, Universitas Sebelas Maret
  • Bhisma Murti Masters Program in Public Health, Universitas Sebelas Maret


Background: Diastasis Recti Abdominis (DRA) is a separation that occurs in the abdominal muscles, namely between the two rectus abdominis muscles. This separation is precisely in the linea alba which is the midline of the abdomen. DRA is characterized by two things, namely the widening of the inter-recti distance (IRD) and the appearance of a bulge in the abdomen. This is due to stretching and weakness of the linea alba. This study aims to analyze the effect of core stability exercise on reducing diastasis recti abdominis in normal postpartum mothers based on the results of a number of previous primary studies.

Subjects and Method: This study uses a meta-analysis method with articles searched using the search keywords "Core stability exercise" AND "diastasis recti abdominis" OR "normal post partum" OR "caliper" OR "ultrasonography" OR "Randomized Controlled Trial" OR "RCT" from PubMed, Google Scholar and Scopus and processed using RevMan 5.3.

Results: 9 RCT articles that fit into the inclusion criteria, with a total of 319 samples. Normal post­partum mothers with diastasis recti abdominis who received core stability exercise had an average caliper score of 4.71 units lower than those without core stability exercise, and the effect was statistically significant (SMD= -4.71; 95% CI -8.05 to -1.37; p= 0.060). Normal postpartum mothers with diastasis recti abdominis who received core stability exercise had an average ultrasound score of 0.80 units lower than those without core stability exercise, and the effect was statistically significant (SMD= -0.80; 95% CI -1.62 to 0.02; p= 0.060). In other words, core stability exercise is effective in reducing diastasis recti abdominis in normal postpartum mothers.

Conclusion: Core stability exercise has an effect on reducing diastasis recti abdominis in mothers after normal delivery.

Keywords: post partum, diastasis recti abdominis, core stability exercise, calipers, ultrasound

Correspondence: Feny Oktaviyani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: fenyokta89@gmail.com. Mobile: +6281312500­575.

Indonesian Journal of Medicine (2022), 07(02): 188-199


Awad E, Mobark A, Zidan AA, Hamada HA, Shousha TM (2021). Effect of progressive prone plank exercise program on diastasis of rectus abdominis muscle in postpartum women: A randomized controlled trial. J. Hum. Sport and Exerc. 16(2proc): S395-S403. doi: 10.14198/jhse.2021.16.Proc2.24.

Bobowik PŻ, Dąbek A (2018). Physiotherapy in women with diastasis of the rectus abdominis muscles. Adv Rehab. 32(3): 11–17. doi: 10.5114/areh.2018.80964.

Gluppe S, Engh ME, Bø K (2021). What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis. Braz J Phys Ther. 25(6): 664-675. doi: 10.1016/j.bjpt.2021.06.006.

Gruszczynska D, Truszczynska-Baszak A (2018). Exercises for pregnant and postpartum women with diastasis recti abdominis - Literature review. Adv Rehab. 32(3): 27–35. doi: 10.5114/areh.2018.80967.

Iqbal MH, Hussain T, Khalid F, Ali MM, Ashraf I, Nazir T (2020). Diastasis Recti Abdominis and Its Associated Risk Factors in Postpartum Women. PAFMJ. 70(5): 1535–1538.

Jessen ML, Öberg S, Rosenberg J (2019). Treatment Options for Abdominal Rectus Diastasis. Front Surg. 6: 65. doi: 10.3389/fsurg.2019.00065.

Kamel DM, Yousif AM (2017). Neuromuscular electrical stimulation and strength recovery of postnatal diastasis recti abdominis muscles. Ann. Phys. Rehabil. Med. 41(3): 465–474. doi: 10.5535/arm.2017.41.3.465.

Keshwani N, Mathur S, McLean L (2021). The impact of exercise therapy and abdominal binding in the management of diastasis recti abdominis in the early post-partum period: a pilot randomized controlled trial. Physiother Theory Pract. 37(9): 1018–1033. doi: 10.1080/09593985.2019.1675 207.

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

Mikolajewicz N, Komarova SV (2019). Meta-Analytic Methodology for Basic Research: A Practical Guide. Front Physiol. 10: 203. doi: 10.3389/fphys.2019.00203.

Nahabedian MY (2018). Management Strategies for Diastasis Recti. Semin Plast Surg. 32(3): 147–153. doi: 10.1055/s-0038-1661380.

Ramesh KS, Hande D (2016). Effects of Abdominal Exercises on Reduction of Diastasis Recti in Postnatal Women. IJHSR. 6(6): 182.

Rustanti M, Zuhri S (2020). Pengaruh Latihan Otot Perut terhadap Diastasis Recti Abdominalis Muscle pada Ibu Pasca Melahirkan Normal (The Effect of Abdominal Muscle Exercise on Diastasis Recti Abdominal Muscle in Normal Postpartum Mothers). JKMSaw. 13(1): 20. doi: 10.26630/jkm.v13i1.2200.

Saleem Z, Khan AA, Farooqui SI, Yasmeen R, Rizvi J (2021). Effect of Exercise on Inter-Recti Distance and Associated Low Back Pain Among Post-Partum Females; A Randomized Controlled Trial. J Family Reprod Health. 15(3): 202–209. doi: 10.18502/jfrh.v15i3.71-39.

Thabet AA, Alshehri MA (2019). Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: A randomised controlled trial. J Musculoskelet Neuronal Interact. 19(1): 62–68.

Triyulianti S, Permata A, Marianda AI, Fisioterapi PSD, Abdurrab U (2021). Jurnal Ilmiah Fisioterapi (JIF) Volume 4 Nomor 02 Agustus 2021 Studi Kasus Pengaruh Terapi Latihan Terhadap Pengurangan Jarak Intra Recti Pada Kondisi Diastasis Recti. 4: 41–44.

Tuttle LJ, Fasching J, Keller A, Patel M, Saville C, Schlaff R, Walker A, Mason M, Gombatto SP (2018). Noninvasive Treatment of Postpartum Diastasis Recti Abdominis: A Pilot Study. JWHPT. 42(2): 65-75. doi: 10.1097/JWH.0000000000000101

Walton LM, Costa A, LaVanture D, McIlrath S and Stebbins B (2016). The effects of a 6 week dynamic core stability plank exercise program compared to a traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, oswestry disability index (ODI) and pelvic floor disability index scores (PFDI). Phys Ther Rehabil. 3: 3. doi: 10.7243/2055-2386-3-3.

Wowiling PE, Sengkey LS, Lolombulan JH (2016). Pengaruh latihan core-strengthening terhadap stabilitas trunkus dan keseimbangan pasien pasca stroke (Effect of core-strengthening exercise on trunk stability and balance in post-stroke patients). JBM. 8(1). doi: 10.35790/jbm.8.1.2016.12334.

Yalfani A, Bigdeli N, Gandomi F (2020). The Effect of Isometric-Isotonic Exercises of Core Stability in Women with Postpartum Diastasis Recti and Its Secondary Disorders (Randomized Controlled Clinical Trial). J. Health Care Mark. 22(2): 132–137.

Yalfani A (2021). The effects of Suspension (TRX) versus core stabilization training on postural stability, lumbopelvic control and proprioception in women with DiastasisRecti Abdominis: A Randomized Controlled Trial. Res. Square. 1–21.