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[Virtual Event] Holding the Line: Does Anything Actually Work to Heal DRA?

Hosted by the Education Review Committee

Thursday, May 30, 2024
6:00 PM - 7:00 PM (EDT)
Zoom Meeting Link (Pass code is 12345)
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Category: Academy Events

Join us for a  deep dive into the evidence for and against non-surgical treatment of diastasis rectus abdominis (DRA).

In this collaborative and engaging workshop, we will review the published research on treatment of DRA to clarify what we can state with confidence  and outline points of confusion or ambiguity that persist in the literature.

We will also discuss the current standard of care for DRA, and draw on both research and practice to identify opportunities for further research and professional collaboration. Allison Romero, PT, DPT and Leah Keller, CPT will present an overview of peer-reviewed literature regarding approaches and outcomes for non-invasive treatment of diastasis rectus abdominis (DRA), outline the current standard of care, and present published findings from a prospective trial with Hospital for Special Surgery (link to the full manuscript provided as a pre-read) in an effort to understand what works, what doesn’t, and where questions persist.

The presenters invite audience participation in a collaborative learning discussion centered around what we see in our practices, where we have questions, and opportunities to work together to advance the research necessary to inform best practices and healing potentials surrounding DRA.

Learning Objectives
At the conclusion of this webinar, participants will:
  1. Describe the current standard of practice for treatment of DRA
  2. Recognize what is currently understood as reasonable or possible healing potentials for DRA according to available literature
  3. Identify points of ambiguity in the published  evidence
  4. Consider potential opportunities and questions for further research topics on the issue

Q&A Session

There will be 15 minutes of Q&A time with the speakers. If you have any questions for the speakers in advance of the webinar, please use our Q&A form below.

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Speakers
  • Allison Romero, PT, DPT
  • Leah Keller, CPT

Moderators

  • Roberta Stergar, PT, DPT, Board-Certified Women's Health Clinical Specialist
  • Karen Snowden, PT, DPT, Board-Certified Women's Health Clinical Specialist
Pre-Readings
  1. Sharma, Geeta MD; Lobo, Tricia BS; Keller, Leah. Postnatal Exercise Can Reverse Diastasis Recti. Obstetrics & Gynecology 123():p 171S, May 2014. | DOI: 10.1097/01.AOG.0000447180.36758.7a
  2. Leopold, Madeline BA1; Santiago, Kristen BA1; Cheng, Jennifer PhD1; Keller, Leah CPT2; Abutalib, Zafir MHS3; Bonder, Jaclyn MD4; Sharma, Geeta MD5; Tenforde, Adam MD6,7; Casey, Ellen MD1. Efficacy of a Core Strengthening Program for Diastasis Rectus Abdominis in Postpartum Women: A Prospective Observational Study. Journal of Women's Health Physical Therapy 45(4):p 147-163, October/December 2021. | DOI: 10.1097/JWH.0000000000000214
  3. Leszek Sułkowski, Andrzej Matyja, Czesław Osuch, Maciej Matyja. Diastasis recti abdominis (DRA): review of risk factors, diagnostic methods, conservative and surgical treatment. Clin. Exp. Obstet. Gynecol. 2022, 49(5), 111. https://doi.org/10.31083/j.ceog4905111
  4. Thabet AA, Alshehri MA. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial. J Musculoskelet Neuronal Interact. 2019 Mar 1;19(1):62-68. PMID: 30839304; PMCID: PMC6454249.
  5. ElHawary, H., Barone, N., Zammit, D. et al. Closing the gap: evidence-based surgical treatment of rectus diastasis associated with abdominal wall hernias. Hernia 25, 827–853 (2021). https://doi.org/10.1007/s10029-021-02460-2
  6. Carlstedt A, Bringman S, Egberth M, et al. Management of diastasis of the rectus abdominis muscles: recommendations for swedish national guidelines. Scandinavian Journal of Surgery. 2021;110(3):452-459. doi:10.1177/1457496920961000
  7. Andréa Soucasse, Arthur Jourdan, Lauriane Edin, Jean-François Gillion, Catherine Masson, Thierry Bege, O43 INTRA-ABDOMINAL PRESSURE VARIATIONS IN HUMANS DURING PHYSICAL EXERCISES AND DAILY LIFE BY INTRAGASTRIC WIRELESS SENSOR, British Journal of Surgery, Volume 108, Issue Supplement_8, November 2021, znab396.042, https://doi.org/10.1093/bjs/znab396.042
  8. Sandra B Gluppe a, Marie Ellström Engh b c, Kari Bø a b.Curl-up exercises improve abdominal muscle strength without worsening inter-recti distance in women with diastasis recti abdominis postpartum: a randomised controlled trial. Journal of Physiotherapy. Volume 69, Issue 3, July 2023, Pages 160-167.
  9. Saleem Z, Khan AA, Farooqui SI, Yasmeen R, Rizvi J. Effect of Exercise on Inter-Recti Distance and Associated Low Back Pain Among Post-Partum Females: A Randomized Controlled Trial. J Family Reprod Health. 2021 Sep;15(3):202-209. doi: 10.18502/jfrh.v15i3.7139. PMID: 34721612; PMCID: PMC8536823.
  10. Skoura, A., Billis, E., Papanikolaou, D.T. et al.Diastasis Recti Abdominis Rehabilitation in the Postpartum Period: A Scoping Review of Current Clinical Practice. Int Urogynecol J 35, 491–520 (2024). https://doi.org/10.1007/s00192-024-05727-1
Disclaimer
Academy volunteer groups and members organize and host webinars throughout the year on a variety of topics to create engaging member-led discussions. Nevertheless, it's important to note that the opinions expressed within hosted webinars do not necessarily represent the views of the Academy of Pelvic Health Physical Therapy, and they should not be interpreted as the official standpoint of the Academy. 

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Speakers

About Allison Romero, PT, DPT

Allison Romero, PT, DPT, RYT is a doctor of physical therapy specializing in core and pelvic health. She owns a private pelvic health practice in the Bay Area of Northern California and also teaches regular women’s health-focused yoga classes. She received her Doctorate of Physical Therapy from the University of Southern California in 2011 and has since devoted her career to understanding pelvic health over the last 13 years. She has spoken at multiple national and international conferences on the importance of pelvic rehabilitation post treatment for pelvic cancers. Allison is a mom of 2 and in her free time loves a juicy read, reality competition shows, and all types of group yoga classes. 

Leah Keller, CPT

Leah Keller, CPT, is the creator and co-founder of Every Mother, an online therapeutic exercise program that grew out of her private training practice in New York City. Leah’s method earned medical validation when researchers at Weill Cornell Medical School collaborated with her to conduct a pilot study with 63 women, all of whom achieved full resolution of diastasis rectus abdominis (AJOG, 2014). Subsequently, a prospective trial performed by Hospital for Special Surgery (JWPHPT, 2021) of the Every Mother online program found improvements in stress urinary incontinence and low back pain among study participants, in addition to clinically significant improvements in DRA. Currently, Leah is working with NYU on a randomized controlled trial examining the role of exercise to improve core and pelvic floor health while reducing menopausal symptoms and improving heart health, metabolic health, muscle mass and bone mineral density. Leah lives in San Francisco with her husband, children and puppy Percy, and she has been featured as a women’s health expert by major media outlets, including NPR and Good Morning America.