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Effects of posture and anatomical location on inter-recti distance measured using ultrasound imaging in parous women

Effects of posture and anatomical location on inter-recti distance measured using ultrasound imaging in parous women
Effects of posture and anatomical location on inter-recti distance measured using ultrasound imaging in parous women
Study design:Cross-sectional repeated measures.Objectives:To quantify the effects of posture and measurement site on the inter-recti distance (IRD) and investigate the reliability of IRD measurement using ultrasound imaging in different postures.Background:The linea alba connects the rectus abdominis muscles anteriorly and the width is known as the IRD. The IRD is usually measured in crook-lying and is the primary outcome measure to assess for a divarication of recti abdominis (DRA). The effects of posture and measurement site on the IRD have not been investigated.Methods:Ultrasound imaging was used to measure IRD in 41 women ≥8 weeks postpartum. The IRD was measured at three sites (superior-umbilicus, umbilicus and inferior-umbilicus), in three postures (crook-lying, sitting and standing), and repeated one-week later. The effects of posture and site were investigated using one-way ANOVAs. Reliability was analysed using Intraclass correlation coefficients (ICCs), Bland Altman analyses, standard error of measurement and minimal detectable change.Results:The IRD was wider when standing vs. lying at both the superior-umbilicus and umbilicus by 0.30 cm (95% CI 0.21 to 0.39) and 0.20 cm (0.11–0.30) respectively (p < 0.001). Measurements at the inferior-umbilicus were, on average, 1.6 and 2.1 cm narrower than superior-umbilicus and umbilicus sites, respectively (p < 0.001). There was high intra-rater reliability within-session (ICC3.3) and between-session (ICC3.1) at all sites measured.Conclusion:The IRD can be measured reliably at all sites and postures. The IRD is wider at superior-umbilicus and umbilicus when upright compared with lying. There is a difference in IRD between all sites measured.
2468-7812
1-7
Gillard, S.
3483f544-965c-47f1-99ad-4ef331493109
Ryan, C.G.
6764bf6b-45f2-43ec-a89a-1e0bad8455d4
Stokes, M.
71730503-70ce-4e67-b7ea-a3e54579717f
Warner, M.
f4dce73d-fb87-4f71-a3f0-078123aa040c
Dixon, J.
d2bde131-2b05-4001-b4c9-31ccf5f31c7f
Gillard, S.
3483f544-965c-47f1-99ad-4ef331493109
Ryan, C.G.
6764bf6b-45f2-43ec-a89a-1e0bad8455d4
Stokes, M.
71730503-70ce-4e67-b7ea-a3e54579717f
Warner, M.
f4dce73d-fb87-4f71-a3f0-078123aa040c
Dixon, J.
d2bde131-2b05-4001-b4c9-31ccf5f31c7f

Gillard, S., Ryan, C.G., Stokes, M., Warner, M. and Dixon, J. (2018) Effects of posture and anatomical location on inter-recti distance measured using ultrasound imaging in parous women. Musculoskeletal Science and Practice, 34, 1-7. (doi:10.1016/j.msksp.2017.11.010).

Record type: Article

Abstract

Study design:Cross-sectional repeated measures.Objectives:To quantify the effects of posture and measurement site on the inter-recti distance (IRD) and investigate the reliability of IRD measurement using ultrasound imaging in different postures.Background:The linea alba connects the rectus abdominis muscles anteriorly and the width is known as the IRD. The IRD is usually measured in crook-lying and is the primary outcome measure to assess for a divarication of recti abdominis (DRA). The effects of posture and measurement site on the IRD have not been investigated.Methods:Ultrasound imaging was used to measure IRD in 41 women ≥8 weeks postpartum. The IRD was measured at three sites (superior-umbilicus, umbilicus and inferior-umbilicus), in three postures (crook-lying, sitting and standing), and repeated one-week later. The effects of posture and site were investigated using one-way ANOVAs. Reliability was analysed using Intraclass correlation coefficients (ICCs), Bland Altman analyses, standard error of measurement and minimal detectable change.Results:The IRD was wider when standing vs. lying at both the superior-umbilicus and umbilicus by 0.30 cm (95% CI 0.21 to 0.39) and 0.20 cm (0.11–0.30) respectively (p < 0.001). Measurements at the inferior-umbilicus were, on average, 1.6 and 2.1 cm narrower than superior-umbilicus and umbilicus sites, respectively (p < 0.001). There was high intra-rater reliability within-session (ICC3.3) and between-session (ICC3.1) at all sites measured.Conclusion:The IRD can be measured reliably at all sites and postures. The IRD is wider at superior-umbilicus and umbilicus when upright compared with lying. There is a difference in IRD between all sites measured.

Text Effects of posture and anatomical location on inter-recti distance measured ACCEPTED - Accepted Manuscript
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More information

Accepted/In Press date: 18 November 2017
e-pub ahead of print date: 22 November 2017
Published date: 1 April 2018

Identifiers

Local EPrints ID: 416241
URI: https://eprints.soton.ac.uk/id/eprint/416241
ISSN: 2468-7812
PURE UUID: 5cccffac-1b8a-472a-8c0f-4a8432963ed7
ORCID for M. Stokes: ORCID iD orcid.org/0000-0002-4204-0890
ORCID for M. Warner: ORCID iD orcid.org/0000-0002-1483-0561

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Date deposited: 08 Dec 2017 17:30
Last modified: 06 Jun 2018 12:47

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