Manual Therapy for Diastasis Recti Abdominis

This randomized, single-blind trial compared the effects of a standardized manual therapy closure protocol, delivered alone or combined with therapeutic exercise, with therapeutic exercise alone on inter-rectus distance (IRD) in women with diastasis recti abdominis (DRA). Sixty-four participants were allocated to one of three groups: a single session of the manual protocol alone; the same protocol followed immediately by therapeutic exercise; or a group performing therapeutic exercise three times per week for three months without the manual protocol. IRD was measured by ultrasound at three abdominal levels, under passive and active conditions, at diagnostic assessment (baseline), immediately after the intervention (manual therapy groups only), and after three months. Secondary outcomes included trunk mobility, respiratory chest excursion, and waist circumference.