{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:32:59Z","timestamp":1790699579131,"version":"4.1.0"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ultrasound imaging has become popular among physiotherapists for monitoring diastasis rectus abdominis postpartum, but its reliability requires further exploration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To investigate physiotherapists\u2019 intra-tester, inter-tester, and test-retest reliability of inter-recti distance measurement utilizing real-time ultrasound across a mixed women sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Reliability study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Volunteers comprising nulliparous and parous women of different ages and body mass index participated. Five physiotherapists performed ultrasound measurements, following sonographic training. Four conditions were tested in supine; rest, curl-up, transversus abdominus activation, and transversus abdominus with curl-up. Three locations were randomly measured: umbilicus, 3 cm above the umbilicus, and halfway between the umbilicus and xiphoid process. For intra-tester reliability, each therapist undertook three repeated measurements. For inter-tester reliability, mean inter-recti distance measurements were explored across any two tester combinations within and across sessions. Test-retest reliability explored repeated measurements 5\u20138 days later. Data were analyzed with intraclass correlation coefficients\n                      <jats:sub>2,1<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>54 women (33.2 \u00b1 15.2 years old, body mass index: 24.2 \u00b1 3.7), 19 (35.2%) being parous participated. Intra-tester reliability across each physiotherapist was very good (intraclass correlation coefficients = 0.677\u20130.989). Intra-session reliability across any two testers yielded very good results (intraclass correlation coefficients = 0.76\u20130.92), whereas across-session yielded good reliability (intraclass correlation coefficients &gt;0.76) except for one condition (3 cm above umbilicus in combined transversus abdominus and curl-up). Test-retest reliability was also very good (intraclass correlation coefficients = 0.78\u20130.96). Significant differences in inter-recti distance were found, with parous women showing consistently larger values (p &lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Physiotherapists, following sonographic training, can reliably measure inter-recti distances in both nulliparous and parous women across active and resting tasks. Thus, ultrasound measurement of inter-recti distance is recommended in physiotherapy practice for monitoring diastasis rectus abdominis and assessing rehabilitation progress. However, sub-umbilical inter-recti distance measurements and the impact of co-contraction on reliability require further research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057251361999","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T10:56:06Z","timestamp":1754996166000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Physiotherapists\u2019 reliability of inter-recti distance measurement with real-time ultrasound across a mixed women population sample"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5828-809X","authenticated-orcid":false,"given":"Evdokia","family":"Billis","sequence":"first","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4446-3970","authenticated-orcid":false,"given":"Anastasia","family":"Skoura","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana-Elena","family":"Papakonstantinou","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9453-5238","authenticated-orcid":false,"given":"Dimitra Tania","family":"Papanikolaou","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tsekoura","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Andriopoulou","sequence":"additional","affiliation":[{"name":"General Hospital Asklipieio Voulas, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charalampos","family":"Matzaroglou","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Lampropoulou","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Koumoundourou","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Hospital of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eftichia","family":"Trachani","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theofani","family":"Bania","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, Rio, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Drakonaki","sequence":"additional","affiliation":[{"name":"Anatomy Department, Medical School, University of Crete, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/68.7.1082"},{"key":"e_1_3_3_3_2","first-page":"49","article-title":"Risk factors for diastasis of the recti abdominis","volume":"97","author":"Candido G","year":"2005","unstructured":"Candido G, Lo T, Janssen P. Risk factors for diastasis of the recti abdominis. J Assoc Chart Physiother Womens Health 2005; 97: 49\u201354.","journal-title":"J Assoc Chart Physiother Womens Health"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2018.07.002"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096065"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2014.09.002"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2018.02.004"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15568"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/JWH.0b013e318276f35f"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzy008"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/JWH.0000000000000101"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1457496920961000"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-024-05727-1"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2006.10.001"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2012.10.013"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.math.2015.09.013"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2011.3507"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12092044"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-023-01443-4"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.4115"},{"issue":"2","key":"e_1_3_3_21_2","first-page":"154","article-title":"The reliability of measuring the inter-recti distance using high-resolution and low-resolution ultrasound imaging comparing a novice to an expert sonographer","volume":"42","author":"Iwan T","year":"2014","unstructured":"Iwan T, Garton B, Ellis R. The reliability of measuring the inter-recti distance using high-resolution and low-resolution ultrasound imaging comparing a novice to an expert sonographer. N Z J Physiother 2014; 42(2): 154\u2013163.","journal-title":"N Z J Physiother"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.3138\/ptc.2015-36"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2017.11.010"},{"key":"e_1_3_3_24_2","first-page":"1","article-title":"Reliability of inter-recti distance measurement on ultrasound images captured by novice examiners","volume":"11","author":"Chmielewska D","year":"2023","unstructured":"Chmielewska D, Cebula M, Gnat R, et al. Reliability of inter-recti distance measurement on ultrasound images captured by novice examiners. Physiother Theory Pract 2023; 11: 1\u20139.","journal-title":"Physiother Theory Pract"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2019.8543"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2016.6536"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.21037\/qims-20-596"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2015.5879"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/JWH.0000000000000130"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/JWH.0000000000000231"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.03.002"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/ca.20836"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-86502007000300005"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2725-z"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2007.2416"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7580.2008.00946.x"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11101396"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.20982\/tqmp.08.1.p023"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2022.113737"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1002\/jum.16430"}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057251361999","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17455057251361999","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057251361999","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:29:33Z","timestamp":1777710573000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17455057251361999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":39,"alternative-id":["10.1177\/17455057251361999"],"URL":"https:\/\/doi.org\/10.1177\/17455057251361999","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"article-number":"17455057251361999"}}