{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:53:32Z","timestamp":1786978412973,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2025,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n The treatment of postpartum diastasis recti abdominis requires a comprehensive approach that considers the integrated function of the core muscle group, rather than focusing solely on the isolated stimulation of the rectus abdominis.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To investigate the effects of inspiratory plus expiratory neuromuscular electrical stimulation in patients with postpartum rectus abdominis separation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Sixty patients diagnosed with postpartum Diastasis Recti Abdominis (DRA) were randomly assigned, using a random number table, to either a control group (\n n<\/jats:italic>\n \u00a0=\u00a030) or an intervention group (\n n<\/jats:italic>\n \u00a0=\u00a030). Both groups participated in a standardized postpartum rehabilitation program for 4\u00a0weeks, consisting of daily 20\u2010min treatment sessions, 5\u00a0days per week. The control group received electrical stimulation targeting the rectus abdominis muscles, whereas the intervention group underwent inspiratory plus expiratory neuromuscular electrical stimulation. To assess the outcomes, a blinded assessor utilized high\u2010frequency ultrasound to measure the separation distance of the rectus abdominis, the thickness of the transversus abdominis, and the thickness of the diaphragm both pre\u2010 and post\u2010intervention. Additionally, the diaphragm thickening ratio was calculated.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At baseline, no significant differences were observed between the two groups. However, following the 4\u2010week intervention, both groups demonstrated significant reductions in rectus abdominis separation (\n p<\/jats:italic>\n \u00a0<\u00a00.05). Notably, the intervention group exhibited significantly greater improvements in rectus abdominis separation at the supra\u2010umbilical and umbilical regions compared with the control group (\n p<\/jats:italic>\n \u00a0=\u00a00.040 and\n p<\/jats:italic>\n \u00a0<\u00a00.001, respectively). Furthermore, the intervention group showed significant increases in diaphragm thickening ratio and transversus abdominis thickness (\n p<\/jats:italic>\n \u00a0=\u00a00.025 and\n p<\/jats:italic>\n \u00a0<\u00a00.001, respectively) relative to the control group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The addition of inspiratory plus expiratory neuromuscular electrical stimulation to conventional postpartum rehabilitation significantly improves outcomes in patients with postpartum DRA. Overall, these findings provide evidence for a novel therapeutic approach that targets both abdominal muscle function and respiratory mechanics, offering a promising direction for the management of DRA in postpartum women.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pri.70069","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:33:59Z","timestamp":1748392439000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Inspiratory Plus Expiratory Neuromuscular Electrical Stimulation on Diastasis Recti Abdominis in Postpartum"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7967-7309","authenticated-orcid":false,"given":"Haimei","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Xie","sequence":"additional","affiliation":[{"name":"School of Exercise and Health Guangzhou Sport University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy School of Health Sciences at Fukuoka International University of Health and Welfare Okawa\u2010shi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongyi","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3009-9406","authenticated-orcid":false,"given":"Wei","family":"Xin","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou China"},{"name":"Curtin School of Population Health Curtin University Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongfeng","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4051-1975","authenticated-orcid":false,"given":"Xiaomei","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports\u20102024\u2010108619"},{"issue":"6","key":"e_1_2_11_3_1","first-page":"549","article-title":"Research Progress on Separation of Rectus Abdominalis After Delivery","volume":"15","author":"Cao Z.","year":"2021","journal-title":"Chinese Journal of Hernia and Abdominal Surgery (electronic edition)"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1457496920961000"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.960847"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/joa.13916"},{"issue":"2","key":"e_1_2_11_7_1","first-page":"201","article-title":"Neuromuscular Electrical Stimulation for Skeletal Muscle Function","volume":"85","author":"Doucet B. 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