Self-reported symptoms in women with diastasis rectus abdominis: A systematic review

Introduction: Diastasis rectus abdominis (DRA) diagnosis via clinical examination is well defined, however, the assessment of symptoms has been less investigated. Currently, there is also scant knowledge on the consequences of DRA. The aim of this review is to identify the relevant self-reported variables in the study of DRA in women. Methods: We performed a systematic review of observational studies through Medline, Embase, and Cochrane Library databases. Studies evaluating the link between DRA and self-reported symptoms were searched using the following terms: "Diastasis rectus abdominis", "Diastasis recti", "Abdominis Rectus Muscle Diastasis", "Questionnaire", "Scale", "Survey", "Interview", "Index" and "Inventory". The methodological quality was assessed independently by two evaluators using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: Fourteen observational studies met the eligibility criteria and were included in the qualitative analysis. Most of the studies were of low to fair quality. Different categories of symptoms were analyzed: quality of life, body image, lumbopelvic pain, other types of pain and pelvic floor dysfunction. A significant positive correlation was found between the presence of DRA and physical health and functioning, abdominal discomfort and body image. Heterogenous data were identified in relation to disability related with low back pain. No correlation has been found between DRA and urinary incontinence, severity and presence of low back pain, voiding symptoms, vaginal symptoms or sexual matters. Conclusions: DRA presents with reduced quality of life due to compromised physical health and functioning; poorer physical perception; lower body image satisfaction; and higher degrees of abdominal pain that is frequently perceived as discomfort or bloating. (C) 2020 Elsevier Masson SAS. All rights reserved.