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RecruitingNCT07628400Updated Jun 5, 2026

Comparative Effects of Hypopressive and Split Tummy Exercises in Postpartum Diastasis Recti

An interventional study of hypopressive exercise and split tummy exercises in Diastasis Recti, sponsored by Riphah International University. Recruiting at 1 site in Pakistan. Open to female participants aged 24 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-06-05.

Sponsored by Riphah International University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jul 2026, 3 months ago, but the record still lists the study as recruiting.
  • Registered 8 months after the study started (first participant enrolled Oct 2025, registered Jun 2026).
  • Started Oct 2025; still recruiting 1 year later.
Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
24 Years to 40 Years
Sex
Female
01

Study summary

To compare the effects of hypopressive exercises and split tummy (transverse abdominal activation-based) exercises on inter-recti distance (IRD), pelvic floor muscle strength and function, and overall quality of life improvements in postpartum women with diastasis recti. This study will be randomized clinical trial and will be conducted in Hameed Latif Hospital Lahore and Civil Hospital Sukkur. The total duration of treatment will be 8 week. Non-probability convenience sampling technique will be used and 50 participants will be recruited in study after randomization. The subjects will be divided into two groups. Group A will receive hypopressive exercise with baseline treatment abdominal binding. Group B will receive baseline treatment with split tummy exercises.

Read the detailed description

Postpartum diastasis recti abdominis (DRA) is a common condition affecting women after childbirth, characterized by the separation of the rectus abdominis muscles along the linea alba. This condition can lead to core instability, pelvic floor dysfunction, back pain, and a negative impact on daily function and quality of life. Rehabilitation through exercise is considered a primary non-surgical treatment. However, the most effective approach to improving both physical parameters and overall lifestyle remains under investigation.

To compare the effects of hypopressive exercises and split tummy (transverse abdominal activation-based) exercises on inter-recti distance (IRD), pelvic floor muscle strength and function, and overall quality of life improvements in postpartum women with diastasis recti. This study will be randomized clinical trial and will be conducted in Hameed Latif Hospital Lahore and Civil Hospital Sukkur. The total duration of treatment will be 8 week. Non-probability convenience sampling technique will be used and 50 participants will be recruited in study after randomization. The subjects will be divided into two groups. Group A will receive hypopressive exercise with baseline treatment abdominal binding. Group B will receive baseline treatment with split tummy exercises. The tools that will be used are digital vernier scale use for inter recti distance, oswestry disability index (ODI), Oxford Grading scale system use for strength and function of pelvic floor muscles and quality of life questionnaire. Data will be analyzed using SPSS version 21. With the significant P value \< 0.05.

02

Conditions studied

  • Diastasis Recti

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Keywords

  • Female
  • Exercise
  • Exercise therapy
  • Pelvic floor
  • Postpartum period
  • Muscle strength.
03

In context

Motor Activity

2,418 studies on the registry are indexed under Motor Activity; 1,162 are open to participants now.

This study's planned enrollment of 50 is below the median of 60 across 2,111 interventional studies indexed under Motor Activity.

Browse Motor Activity studies →

Lead sponsor

Riphah International University is the lead sponsor of 2,133 studies on the registry; 633 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
24 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Age: 24 to 40years
  • Weight: 50 to 70kg
  • Height: 4.5 to 6ft
  • BMI: Both underweight and overweight/ obese individuals can experience DRA.
  • Parity: Multiparous
  • Mode of delivery: vaginal delivery in split tummy.
  • Subjects who gave vaginal birth with or without episiotomy in multiparous women in hypopressive.

Exclusion criteria

Exclusion Criteria:

  • Undergoing a severe illness
  • Uncompleted inter-rectus distance (IRD) records
  • Have a history of pelvic floor dysfunction
  • Primiparous, polyhydramnios, uterine fibroids during pregnancy, previous abdominal, surgery caesarean delivery
  • Subjects with untreated high blood pressure, cardiovascular illness, hernia, pregnant and underwent any recent surgeries.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
50 participants (estimated)

Study arms

  • Active comparator
    hypopressive exercise

    For participants in Group A, series of postural and breathing-based sequences will be given. Base-line is abdominal binding I will performed hypopressive exercises in various positions (lying, sitting, leaning forward, standing and quadruped) to improve breath control, abdominal contraction and pelvic floor engagement. Each session began with focused breathing, full increasing based on tolerance. Exercises were repeated in different postures to assess endurance in each, as individual holding each contraction 5 seconds and relax for 10 seconds capacity varied by position. Participants engaged in these exercises for 20 minutes, 3 times per week, over a 8 week period, with moderate to high intensity based on breath-hold duration and postural demand.

    Other: hypopressive exercise

  • Experimental
    split tummy exercises

    Base-line abdominal binding I will perform isometric exercises (1) Modified plank hold (2) Pelvic tilts (3) Transverse abdominis engagement. For modified plank hold in this position participants with their knees on the ground instead of toes. Engage core muscles and hold for 30 to 60 seconds. For pelvic tilts participants lie on back with knees bent and feet flat on the floor. Tilt the pelvic upwards and then back down again, repeating the motion in a slow and controlled manner. Hold for 30 to 60 seconds. For transverse abdominis engagement participants lies on back with knees bent and feet flat on the floor. Engage transverse abdominis muscle and drawing belly button towards spine. Hold for 30 to 60 seconds. 3 times in a week involving at least three sets of 10 repetitions each. To improved core strength and stability, increased muscle endurance and isometric exercises can be low-impact, making them suitable for individuals with diastasis recti.

    Other: split tummy exercises

Interventions

  • Otherhypopressive exercise

    For participants in Group A, series of postural and breathing-based sequences will be given. Base-line is abdominal binding I will performed hypopressive exercises in various positions (lying, sitting, leaning forward, standing and quadruped) to improve breath control, abdominal contraction and pelvic floor engagement. Each session began with focused breathing, full increasing based on tolerance. Exercises were repeated in different postures to assess endurance in each, as individual holding each contraction 5 seconds and relax for 10 seconds capacity varied by position. Participants engaged in these exercises for 20 minutes, 3 times per week, over a 8 week period, with moderate to high intensity based on breath-hold duration and postural demand.

  • Othersplit tummy exercises

    Base-line abdominal binding I will perform isometric exercises (1) Modified plank hold (2) Pelvic tilts (3) Transverse abdominis engagement. For modified plank hold in this position participants with their knees on the ground instead of toes. Engage core muscles and hold for 30 to 60 seconds. For pelvic tilts participants lie on back with knees bent and feet flat on the floor. Tilt the pelvic upwards and then back down again, repeating the motion in a slow and controlled manner. Hold for 30 to 60 seconds. For transverse abdominis engagement participants lies on back with knees bent and feet flat on the floor. Engage transverse abdominis muscle and drawing belly button towards spine. Hold for 30 to 60 seconds. 3 times in a week involving at least three sets of 10 repetitions each. To improved core strength and stability, increased muscle endurance and isometric exercises can be low-impact, making them suitable for individuals with diastasis recti.

06

What researchers measure

Primary outcomes

  1. Digital Vernier Calliper

    The Oswestry Disability Index (ODI) and inter-recti distance were measured at the start (baseline) and again at the 8th week. A digital vernier caliper was used to assess the inter-recti distance at three specific locations: directly at the umbilicus, 4.5 cm above, and 4.5 cm below it. The ODI evaluates functional disability based on ten factors: pain intensity, ability to maintain personal hygiene, lifting, work, standing, sitting, sleeping, sexual activity, social interaction, and travel. ODI scores range as follows: 0-20% indicates minimal disability, 21-40% suggests moderate disability, 41-60% reflects severe disability, 61-80% indicates significant functional limitation, and 81-100% implies the patient is confined to bed.

    Time frame: 8 weeks

  2. Quality of life questionnaire

    The SF-36 is regarded as a valid and reliable tool with strong discriminatory and convergent validity that allows it to differentiate across respondent groups according to age, gender, and socioeconomic position. It has eight sub scales and 36 items. (1) Physical functioning (PF), (2) Role-physical (RP), (3) Bodily pain (BP), (4) General health (GH), (5) Vitality (VT), (6) Social functioning (SF), (7) Role-emotional (RE), and (8) Emotional wellbeing (EW). Higher ratings on each subscale, which range from 0 to 100, indicate better conditions .

    Time frame: 8 weeks

  3. Pelvic floor strength and function

    Digital assessment of PFM strength using the Oxford Grading Scale system will distributed as follows: weak (n = 1), moderate (n = 6), good (n = 10) and strong (n = 26)(16). The reliability of oxford grading scale system is 0.53.

    Time frame: 8 weeks

07

Study locations

1 of 1 sites recruiting
  • Civil Hospital Sukkur
    Sukkur, Punjab Province 65200, Pakistan
    • Sarah Abid, MSWHPT · Principal investigator
    Recruiting
08

References and documents

Publications

  • Abdullah, Rehman KA, Ahmad B, Arshad MK, Saeed H, Keen MA, Anwar A, Saleem NUA, Salma Shabbar Banatwala UE, Bilal Z, Shahzad M, Shakoor P, Niazi MA. Comparative Efficacy of Abdominal Exercises and Abdominal Binding on Diastasis Recti Abdominis Reduction in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Physiother Res Int. 2025 Apr;30(2):e70038. doi: 10.1002/pri.70038. PubMed 40018828 ↗
  • Rodriguez-Romero B, Senin-Camargo F, Sande-Fuentes J, Martinez-Bustelo S. Exercises to treat diastasis rectus abdominis and improve abdominal function: Two case reports. J Back Musculoskelet Rehabil. 2025 Sep;38(5):1180-1188. doi: 10.1177/10538127251325839. Epub 2025 Apr 10. PubMed 40208059 ↗
  • Theodorsen NM, Moe-Nilssen R, Bo K, Haukenes I. Effect of exercise on the inter-rectus distance in pregnant women with diastasis recti abdominis: an experimental longitudinal study. Physiotherapy. 2023 Dec;121:13-20. doi: 10.1016/j.physio.2023.08.001. Epub 2023 Aug 23. PubMed 37812848 ↗
  • Sekar R, Ramalingam V, Nirmala JG, Muniandy Y. Effectiveness of Abdominal Hypopressive Technique on Diastasis Recti among Postpartum Women. Indian Journal of Physiotherapy & Occupational Therapy. 2024;18.
  • Shohaimi S, Husain NRN, Zaki FM, Atan IK. Split Tummy Exercise Program for Reducing Diastasis Recti in Postpartum Primigravidae: A Randomized Controlled Trial. Korean J Fam Med. 2023 Mar;44(2):102-108. doi: 10.4082/kjfm.22.0035. Epub 2023 Mar 20. PubMed 36966740 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 5, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07628400
Lead sponsor
Riphah International University
Responsible party
Sponsor
First posted
Jun 5, 2026
Start date
Oct 1, 2025
Primary completion
Jul 1, 2026 (estimated)
Completion
Jul 1, 2026 (estimated)
Last update
Jun 5, 2026

Study contacts

Imran Amjad, PhD
Contact
imran.amjad@riphah.edu.pk
03324390125
Hafiza Iqra Rubab, MSWHPT
principal investigator · Riphah International University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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