Effects of Barre-Based Core Stability With and Without Tupler Technique on Core Strength, Inter Recti Distance, and Pelvic Floor Function Among Diastasis Recti Abdominis Patients

NCT07731724 | Recruiting

• 1 other identifier: UBAS/ERB/26/04/016
• Study Type: interventional
• Target: 58
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be a single blind, parallel group randomized controlled trial designed to evaluate the effectiveness of Barre-based core stability training with and without the Tupler Technique in postpartum women with Diastasis Recti Abdominis. A total of 58 eligible participants will be recruited from postpartum care units and randomly assigned in a 1:1 allocation ratio to either an experimental group receiving Barre-based core stability training combined with the Tupler Technique or a control group receiving Barre-based core stability training alone. Both interventions will be delivered under supervised conditions three times per week for 8 weeks, with each session lasting approximately 30-45 minutes. The Barre-based program focuses on controlled low impact movements aimed at improving deep core muscle activation, postural alignment, and neuromuscular coordination. The experimental group will additionally receive the Tupler Technique, which includes abdominal splinting, progressive core strengthening exercises, and neuromuscular re-education targeting approximation of the rectus abdominis muscles and improved abdominal wall function. Outcome measures include inter-recti distance, core strength, and pelvic floor function. Secondary outcomes include postural stability and functional performance. Assessments will be conducted at baseline, mid-intervention (week 4), post-intervention (week 8), and follow-up (week 12) by blinded outcome assessors to minimize bias. The purpose of this trial is to determine whether combining the Tupler Technique with Barre-based core stability training provides superior improvements in abdominal separation, core strength, pelvic floor function, and functional ability compared with Barre-based training alone in postpartum women.

Conditions

Diastasis Recti Abdominis (Postpartum)

Keywords

Diastasis Recti Abdominis, Postpartum, Core Stability, Barre Training, Tupler Technique, Inter-Recti Distance, Pelvic Floor

Outcome Measures

Primary Outcomes (5)

• Inter-Recti Distance (IRD)

  Inter-recti distance (IRD) will be measured to assess the separation of the rectus abdominis muscles in women with Diastasis Recti Abdominis. Measurements will be taken using ultrasound imaging and calipers at standardized anatomical points (above, at, and below the umbilicus). IRD will be recorded in centimeters. A reduction in IRD indicates improvement in abdominal wall integrity and core stability.

  Baseline (Day 0), Week 4, Week 8, Week 12

• Core Strength

  Core strength will be assessed using the Modified Sahrmann Test, which evaluates lumbopelvic control and activation of deep core muscles during progressive lower limb movements. Performance will be scored based on the ability to maintain neutral spine alignment without compensatory movements such as pelvic tilt or abdominal bulging. Higher scores indicate better core strength and neuromuscular control.

  Baseline (Day 0), Week 4, Week 8, Week 12

• Pelvic Floor Function

  Pelvic floor function will be assessed using the Pelvic Floor Distress Inventory (PFDI-20), a validated questionnaire measuring symptom severity related to urinary, colorectal, and prolapse distress. Scores range from 0 to 300, with higher scores indicating greater dysfunction. A reduction in score indicates improvement in pelvic floor function.

  Baseline (Day 0), Week 4, Week 8, Week 12

• Postural Stability

  Postural Stability Postural stability will be assessed using the Balance Error Scoring System (BESS). Participants perform balance tasks in double-leg, single-leg, and tandem stance on firm and foam surfaces. Errors (e.g., stepping, loss of balance, opening eyes) are counted. Lower scores indicate better postural control.

  Baseline (Day 0), Week 4, Week 8, Week 12

• Functional Performance

  Functional performance will be assessed using the Physical Functioning (PF-10) subscale of the SF-36 Health Survey. The scale evaluates limitations in activities such as walking, climbing stairs, lifting, and carrying objects. Scores range from 0 to 100, with higher scores indicating better functional ability.

  Baseline (Day 0), Week 4, Week 8, Week 12

Study Arms (2)

Barre-Based Core Stability with Tupler Technique (BBT+TT)

EXPERIMENTAL

Participants will receive supervised Barre-based core stability training combined with the Tupler Technique. The Barre program will include low impact controlled exercises such as pelvic tilts, glute bridges, modified planks, lower limb core controlled movements, and functional standing exercises to improve deep core activation and postural control. The Tupler Technique component will include abdominal splinting, elevator exercises, and structured neuromuscular re-education aimed at reducing inter recti distance and improving abdominal wall integrity. Sessions will be conducted three times per week for 8 weeks, with each session lasting 30-45 minutes.

Behavioral: Barre-Based Core Stability Training (BBT); Behavioral: Tupler Technique

Barre-Based Core Stability Training (BBT)

ACTIVE COMPARATOR

Participants will receive supervised Barre-based core stability training alone. The program will include low-impact controlled exercises such as pelvic tilts, glute bridges, modified planks, lower limb core-controlled movements, and functional standing exercises aimed at improving deep core muscle activation, postural alignment, and functional stability. No Tupler Technique components such as abdominal splinting or neuromuscular re-education will be included. Sessions will be conducted three times per week for 8 weeks, with each session lasting 30-45 minutes.

Behavioral: Barre-Based Core Stability Training (BBT)

Interventions

Barre-Based Core Stability Training (BBT) BEHAVIORAL

Barre-Based Core Stability Training is a low impact, structured exercise intervention designed to improve deep core muscle activation, postural alignment, and functional stability. It will include controlled movements such as pelvic tilts, glute bridges, modified planks, lower limb core-controlled exercises, and functional standing activities. The program will emphasize activation of the transversus abdominis and pelvic floor muscles through slow, controlled, and alignment focused exercises. Sessions will be conducted under supervision three times per week for 8 weeks, with each session lasting 30-45 minutes. This intervention will aim to enhance core strength, improve neuromuscular coordination, and support overall lumbopelvic stability.

Barre-Based Core Stability Training (BBT); Barre-Based Core Stability with Tupler Technique (BBT+TT)

Tupler Technique BEHAVIORAL

The Tupler Technique is a structured rehabilitation program specifically designed for the management of Diastasis Recti Abdominis. It will include abdominal splinting, progressive core strengthening exercises, and neuromuscular re-education techniques. The program will focus on activating and strengthening the transversus abdominis while promoting approximation of the rectus abdominis muscles to reduce inter-recti distance. Key components will include elevator exercises, controlled core engagement, and the use of abdominal support during functional activities to enhance abdominal wall integrity. In this study, the Tupler Technique will be delivered in combination with Barre-based training over 8 weeks with supervised sessions three times per week.

Barre-Based Core Stability with Tupler Technique (BBT+TT)

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Women aged 18-40 years
• Postpartum period between 6-12 months
• Diagnosed with stage I-II Diastasis Recti Abdominis
• Presence of symptoms such as abdominal weakness or back pain

You may not qualify if:

• Stage III Diastasis Recti Abdominis
• Severe hernias or significant pelvic floor dysfunction
• Neurological, cardiovascular, or systemic conditions contraindicating exercise
• History of abdominal surgery or trauma affecting the abdominal wall

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences: lead

Study Sites (1)

Punjab Rangers Teaching Hospital (PRTH), Ghurki Trust Teaching Hospital (GTTH)

Lahore, Punjab Province, Pakistan

RECRUITING

Study Officials

• WHO

  Lahore University of Biological and Applied Sciences

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Hafsa Liaquat

CONTACT

0349-4202195; hafsaliaquat39@gmail.com

Dr. Sahar Fatima

CONTACT

0327-1202200; Sahar.fatime@ubas.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: This will be a single blinded study in which the outcome assessors and data collectors will be blinded to group allocation to minimize assessment bias. Participants and therapists will not be blinded due to the nature of the exercise interventions.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 23, 2026
• First Posted: July 28, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): August 15, 2026
• Study Completion (Estimated): October 15, 2026
• Last Updated: July 28, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)