Diastasis recti abdominis, contributions of physiotherapy to functional recovery and quality of life: A literature review

Abstract

Introduction: Diastasis of the rectus abdominis muscles (DRAM) is characterised by the separation of these muscles along the linea alba and is prevalent among women during pregnancy and the postpartum period. This condition can lead to low back pain, lumbopelvic instability, and functional and aesthetic impairment, as well as negatively affecting self-esteem and emotional well-being. Physiotherapy represents a safe and effective conservative approach, focusing on core activation, postural re-education, and improvement of overall functionality. Objective: This study describes the benefits of physiotherapeutic interventions identified in the literature for the treatment of DRAM in postpartum women, considering their effects on reducing muscle separation, alleviating symptoms, and improving quality of life. Methods: This integrative literature review was conducted using the descriptors “diástase abdominal,” “fisioterapia,” “pós-parto,” “abdominal diastasis,” and “rehabilitation,” combined with Boolean operators. Only articles published in the last 15 years in scientific journals and indexed repositories were included. Studies were eligible if they presented explicit methodology, empirical data, or a structured review, ensuring scientific quality and methodological rigor. A total of 12 articles were identified, and after applying eligibility criteria, the studies were analysed regarding their objectives, methods, and reported therapeutic outcomes. Results: The studies show that techniques such as kinesiotherapy, hypopressive exercises, electrostimulation, and biofeedback promote reductions in inter-rectus distance, improvements in lumbopelvic stability, increased abdominal strength, and postural gains. Combined approaches demonstrated greater effectiveness, emphasising the importance of physiotherapeutic supervision and postural education in preventing recurrence. Evidence also indicates improvements in self-esteem and quality of life among postpartum women. Conclusion: Physiotherapy is confirmed as the first-line approach for the treatment of DRAM, providing significant physical and psychosocial benefits. However, methodological heterogeneity and the lack of standardised protocols highlight the need for robust clinical trials with longer follow-up to strengthen the scientific evidence base and optimise therapeutic guidelines.