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The Role of Physiotherapy

par Caufriez, Marcel ;Botanica, Fabrizio
Référence New Concepts in Diastasi Recti Surgery: Minimally Invasive Surgical Techniques and Patient Management, Springer Nature, page (183-199)
Publication Publié, 2024-01

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Résumé :

The role of physiotherapy in rectus abdominis diastasis has been widely studied, especially during postpartum periods. However, only recently in cases where surgery becomes necessary has this option been further looked into. The importance of physiotherapy along with other alternative treatments has been evidenced in a new TOR (training, operation, and rehabilitation) approach. Rectus abdominis diastasis must not be considered an isolated pathology but rather as an imbalance of the so-called “core” abdominal functional unit which includes the anterior abdominal wall, the diaphragm, the pelvic floor muscles, and the lumbar column. Given the complexity of this functional unit, the physiotherapeutic treatment requires an accurate evaluation (both objective and instrumental) in order to prepare the patient at best for surgery, thus warding off complications and relapses. Furthermore, an adequate preoperative treatment will speed up postoperative recovery. The treatment must especially take into consideration the role of collagen, the abdominal pressure involved, and the role played by the diaphragm. In addition the inter- and intra-muscular coordination of the anterior abdominal wall and the pelvic floor must also be considered. The rehabilitation treatment thus includes manual therapy, specific exercises to deal with the muscles, and the abdominal pressure as well as instrumental treatments such as TECAR, RUSI, and biofeedback.