Effects of Drawing in Maneuver and Resisted Ankle Dorsiflexion in Postpartum Diastasis Recti

NCT07520409 | Recruiting

• 1 other identifier: REC/RCR&AHS/25/0504
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to compare the combine effects of drawing in maneuver and resisted ankle dorsiflexion on pain, inter-recti distance, strength and quality of life in postpartum diastasis recti.

Conditions

Diastasis Recti

Keywords

ankle; Postpartum Period; Muscle Strength; Quality of Life; Resistance training

Outcome Measures

Primary Outcomes (4)

• Numeric Pain Rating Scale

  This scale examines the subjective degree of pain severity is estimated using a horizontal line on a standardized self-reporting scale. The pain level is represented by an 11-point numerical scale. There is no pain (0), mild pain (1-2-3), moderate pain (4-5-6), and severe pain (7-8-9-10).

  6th week

• Caliper Measurement

  To assess inter-recti distance at reference points (above, at, and below the umbilicus) the caliper will be used. To measure inter-recti distance 4.5 cm above and below the umbilicus (indicated with skin markings), the inside jaws of the calipers are placed between the medial edges of the right and left rectus abdominis muscles as palpated by the examiner

  6th week

• Manual Muscle Testing (MMT)

  . Manual Muscle Testing (MMT) is a widely used clinical method to evaluate the strength of individual muscles or muscle groups on a standardized 0 to 5 scale. A grade of 0 indicates no visible or palpable muscle contraction, while 1 (Trace) denotes a slight muscle flicker without any movement. A grade 2 (Poor) means the muscle can complete full range of motion only when gravity is eliminated. Grade 3 (Fair) signifies the ability to move the joint through the full range of motion against gravity, but not against any resistance. Grade 4 (Good) indicates that the muscle can perform against moderate resistance, and grade 5 (Normal) represents full strength with the ability to resist maximal manual pressure

  6th week

• SF-36

  The SF-36 (Short Form-36 Health Survey) is a validated and reliable questionnaire used to assess health-related quality of life across eight domains, including physical functioning, bodily pain, general health, vitality, social functioning, and mental health. Each domain is scored from 0 to 100, with higher scores indicating better quality of life

  6th week

Study Arms (2)

DRAWING IN MANEUVER & RESISTED ANKLE DORSIFLEXION

EXPERIMENTAL

Drawing-In Maneuver (DIM), also known as the abdominal drawing-in maneuver, which is widely recognized as a foundational exercise for deep core activation

Other: DRAWING IN MANEUVER; Other: RESISTED ANKLE DORSIFLEXION

DRAWING IN MANEUVER

ACTIVE COMPARATOR

Resisted Ankle Dorsiflexion contributes to core muscle engagement through kinetic chain activation.

Other: DRAWING IN MANEUVER

Interventions

DRAWING IN MANEUVER OTHER

Each contraction will be held for 10 seconds and repeated 10 times per session. This exercise will be performed two to three times per week for six weeks

DRAWING IN MANEUVER; DRAWING IN MANEUVER & RESISTED ANKLE DORSIFLEXION

RESISTED ANKLE DORSIFLEXION OTHER

They will dorsiflex the ankle, pulling the toes toward the shin against the resistance, hold for 5-10 seconds, and then return to the starting position. Each leg will complete three sets of 10 repetitions, performed two to three times weekly

DRAWING IN MANEUVER & RESISTED ANKLE DORSIFLEXION

Eligibility Criteria

• Age: 20 Years - 45 Years
• Gender Eligibility Details: postpartum diastasis recti
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Postpartum females (6 weeks to 6 months postpartum)
• Diagnosed with diastasis recti (IRD ≥ 2.5 cm)
• Age 20-45 years
• Mode of delivery
• Multiparity

You may not qualify if:

• History of abdominal surgery
• Pelvic organ prolapses
• Neurological or orthopedic disorders
• Presence of low back pain, hernia, or musculoskeletal disorders
• Participation in any other abdominal rehabilitation program in the last 3 months

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Al Zahra Hospital

Guiranwala, Punjab Province, 52250, Pakistan

RECRUITING

Related Publications (5)

• Cavalli M, Aiolfi A, Bruni PG, Manfredini L, Lombardo F, Bonfanti MT, Bona D, Campanelli G. Prevalence and risk factors for diastasis recti abdominis: a review and proposal of a new anatomical variation. Hernia. 2021 Aug;25(4):883-890. doi: 10.1007/s10029-021-02468-8. Epub 2021 Aug 6.

  PMID: 34363190 BACKGROUND

• Berg-Poppe P, Hauer M, Jones C, Munger M, Wethor C. Use of exercise in the management of postpartum diastasis recti: a systematic review. The Journal of Women's & Pelvic Health Physical Therapy. 2022;46(1):35-47.

  BACKGROUND

• Tung RC, Towfigh S. Diagnostic techniques for diastasis recti. Hernia. 2021 Aug;25(4):915-919. doi: 10.1007/s10029-021-02469-7. Epub 2021 Jul 27.

  PMID: 34313855 BACKGROUND

• Beamish NF, Davenport MH, Ali MU, Gervais MJ, Sjwed TN, Bains G, Sivak A, Deering RE, Ruchat SM. Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis. Br J Sports Med. 2025 Mar 31;59(8):562-575. doi: 10.1136/bjsports-2024-108619.

  PMID: 39694630 BACKGROUND

• Laframboise FC, Schlaff RA, Baruth M. Postpartum Exercise Intervention Targeting Diastasis Recti Abdominis. Int J Exerc Sci. 2021 Apr 1;14(3):400-409. doi: 10.70252/GARZ3559. eCollection 2021.

  PMID: 34055160 BACKGROUND

Study Officials

• hina gul, PhD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

imran amjad, PhD*

CONTACT

03324390125; imran.amjad@riphah.edu.pk

imran amjad

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 2, 2026
• First Posted: April 9, 2026
• Study Start: October 1, 2025
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: June 9, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)