Effect of exercise intervention on self-efficacy, abdominal circumference and spacing of rectus abdominis separation in patients with postpartum rectus abdominis separation
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摘要:
目的 探索运动干预改善产后腹直肌分离患者自我效能、腹围及腹直肌分离间距的效果,为临床运动干预提供参考依据。 方法 选取2022年8月—2023年3月就诊于蚌埠医学院第二附属医院康复科的产后腹直肌分离患者86例,按照就诊时间分为对照组(43例)和干预组(43例)。2组均进行常规的康复训练,干预组在此基础上进行运动干预。干预前后采用自我效能感量表(GSES)评估患者的自我效能,并测量患者的腹围及腹直肌分离间距。 结果 2组患者干预前比较,各项指标差异均无统计学意义(均P>0.05)。干预后,2组患者的腹围均减少,且干预组腹围[(81.67±7.09)cm]小于对照组[(84.42±6.72)cm],差异有统计学意义(t=2.071, P=0.045);2组患者的三处腹直肌分离间距均有所减小(均P < 0.05),且干预后干预组腹直肌分离间距脐上2 cm处[(1.37±0.50)cm]、平脐处[(1.74±0.50)cm]、脐下2 cm处[(1.24±0.53)cm]均小于对照组的间距[(1.60±0.42)cm、(1.95±0.38)cm、(1.44±0.37)cm],差异有统计学意义(均P < 0.05);2组患者自我效能均提高(均P < 0.05),且干预组自我效能感更好(P < 0.05);比较2组患者干预前后腹围、腹直肌分离间距及自我效能感评分的差值,干预组患者的改善情况优于对照组(均P < 0.05)。 结论 运动干预可以减小产后腹直肌分离患者的腹围及腹直肌分离间距,提高产妇的自我效能感,能够有效促进产后恢复,具有较高的临床推广价值。 Abstract:Objective To explore the effect of exercise intervention on improving self-efficacy, abdominal circumference and separation distance of rectus abdominis in postpartum patients with separation of rectus abdominis, and to provide reference for clinical exercise intervention. Methods Eighty-six patients with postpartum rectus abdominis separation who attended the rehabilitation department of the Second Affiliated Hospital of Bengbu Medical College from August 2022 to March 2023 were selected and divided into a control group (n=43) and an intervention group (n=43) according to the time of consultation; both groups underwent conventional rehabilitation training, and the intervention group underwent exercise intervention on this basis. Patients ' self-efficacy was assessed using the general self-efficacy scale (GSES) before and after the intervention, and abdominal circumference and the separation distance between the rectus abdominis muscles were measured. Results Comparing the two groups of patients before intervention, there was no significant difference in the indicators (all P>0.05). After intervention, the abdominal circumference of patients in both groups was reduced, and the abdominal circumference of the intervention group [(81.67±7.09) cm] was smaller than that of the control group [(84.42±6.72) cm], with statistically significant differences (t=2.071, P=0.045). The separation distance of the three rectus abdominis muscles in both groups decreased (all P < 0.05), and the separation distance of the rectus abdominis muscles 2 cm above the umbilicus [(1.37±0.50) cm], at the flat umbilicus [(1.74±0.50) cm] and below the umbilicus [(1.24±0.53) cm] in the intervention group were smaller than those of the control group [(1.60±0.42), (1.95±0.38) and (1.44±0.37) cm], and the differences were statistically significant (all P < 0.05). The self-efficacy of patients in both groups increased (all P < 0.05), and was better in the intervention group (P < 0.05). Compared the differences in abdominal circumference, rectus abdominis separation distance and self-efficacy score between the two groups before and after intervention, the improvement of the intervention group was better than that of the control group (all P < 0.05). Conclusion Exercise intervention can reduce the abdominal circumference and distance between diastasis recti abdominis in patients with postpartum diastasis and improve maternal self-efficacy, which can effectively promote postpartum recovery and has high clinical promotion value. -
Key words:
- Postpartum /
- Rectus abdominis separation /
- Exercise rehabilitation /
- Self-efficacy
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表 1 2组产后腹直肌分离患者一般资料比较
Table 1. Comparison of general data between 2 groups of patients with diastasis recti postpartu
组别 例数 年龄(x±s,岁) 生产方式[例(%)] 胎次[例(%)] 产后时间(x±s,d) 顺产 剖宫产 一胎 二胎 对照组 43 30.81±2.74 30(69.77) 13(30.23) 25(58.14) 18(41.86) 61.86±15.59 干预组 43 30.04±3.20 26(60.47) 17(39.53) 24(55.81) 19(44.19) 57.14±14.72 统计量 1.257a 0.819b 0.047b 1.268a P值 0.216 0.365 0.828 0.212 注:a为t值,b为χ2值。 表 2 2组产后腹直肌分离患者腹围比较(x±s,cm)
Table 2. Comparison of abdominal circumference between two groups of patients with diastasis recti postpartum (x±s, cm)
组别 例数 干预前 干预后 对照组 43 88.47±8.36 84.42±6.72a 干预组 43 87.80±6.58 81.67±7.09a t值 0.441 2.071 P值 0.662 0.045 注:与同组干预前比较,aP<0.05。 表 3 2组产后腹直肌分离患者腹直肌分离间距比较(x±s,cm)
Table 3. Comparison of rectus abdominis separation distance between 2 groups of patients with diastasis recti postpartum (x±s, cm)
组别 例数 脐上2 cm 平脐 脐下2 cm 干预前 干预后 干预前 干预后 干预前 干预后 对照组 43 2.27±0.57 1.60±0.42a 3.16±0.40 1.95±0.38a 2.12±0.52 1.44±0.37a 干预组 43 2.56±0.72 1.37±0.50a 3.37±0.54 1.74±0.50a 2.33±0.82 1.24±0.53a t值 1.963 2.075 1.983 2.216 1.263 2.129 P值 0.056 0.044 0.054 0.032 0.214 0.039 注:与同组干预前比较,aP<0.05。 表 4 2组产后腹直肌分离患者自我效能感量表评分比较(x±s,分)
Table 4. Comparison of self-efficacy scale scores between two groups of patients with diastasis recti postpartum (x±s, points)
组别 例数 干预前 干预后 对照组 43 25.74±1.40 27.02±2.28a 干预组 43 26.51±2.20 29.28±2.43a t值 1.943 4.412 P值 0.059 <0.001 注:与同组干预前比较,aP<0.05。 表 5 2组产后腹直肌分离患者腹围、腹直肌分离间距及自我效能感评分干预前后差值比较
Table 5. Comparison of abdominal circumference, separation distance, and self-efficacy scale scores between two groups of patients with diastasis recti postpartum
组别 例数 腹围的差值(x±s,cm) 腹直肌间距的差值(x±s,cm) 自我效能差值[M(P25, P75),分] 脐上2 cm 平脐 脐下2 cm 对照组 43 -3.31±1.45 -0.76±0.33 -1.17±0.31 -0.77±0.44 0.98(0.72,1.23) 干预组 43 -5.27±1.46 -1.17±0.58 -1.63±0.35 -1.08±0.56 2.77(2.43,3.10) 统计量 6.295a 4.257a 6.854a 2.695a -6.524b P值 <0.001 <0.001 <0.001 0.010 <0.001 注:a为t值,b为Z值。 -
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