The Reliability of Measuring Diastasis Recti Abdominis in Pregnant Women Using Ultrasound
Introduction: Diastasis recti abdominis is defined as an excessive separation of the two rectus abdominis muscles along the linea alba. Ultrasonography is a reasonably priced, non-invasive, repeatable, and safe method of measuring the excessive separation in pregnancy. The obtained values are in scale of millimetres and such changes are hard to be distinguished by palpation. We aimed to determine the intra-rater and the inter-rater reliability in measuring diastasis recti abdominis in pregnant women with the use of an ultrasound machine.
Methods: Ultrasound imaging was used to measure diastasis recti abdominis in 20 pregnant volunteers. Two qualified physiotherapists performed measurements 4.5 cm above the superior margin of the umbilicus and 4.5 cm below the inferior margin of the umbilicus, as well as in the position of a relaxed abdominal wall and while performing an abdominal crunch. The reliability was assessed by the intra-class correlation coefficient (ICC).
Results: The intra-rater reliability above the umbilicus in both positions was very good. In measurements below the umbilicus, the reliability was moderate to very good. Reliability among raters in measurements above and below the umbilicus and in both positions was good.
Conclusion: Ultrasonography is a reliable method to assess diastasis recti abdominis in pregnant women if the measurements are taken by a single physiotherapist or by two different physiotherapists. The key to achieving higher reliability is experience and continuous professional education.
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