The reliability and validity of a telehealth-instructed self-assessment of Inter-rectus Distance to diagnose Diastasis Rectus Abdominis

Abstract

INTRODUCTION: Approximately 3.8 million women give birth every year in the U.S. Fifty-six percent of postpartum women indicate that pain interferes in daily activities. One cause of physical impairment is Diastasis Rectus Abdominis (DRA), which is an overstretching and/or separation of the left and right rectus abdominis muscles from their attachments along the linea alba in the middle of the abdomen. DRA is prevalent in up to 83% of postpartum women and has been shown to cause decreased abdominal strength, pain in the pelvic girdle low back, or abdomen, and urinary incontinence. The gold-standard to measure IRD is real-time ultrasonography. However, amid the COVID-19 pandemic, assessments of IRD for diagnosing DRA relies on women's self-assessment guided by clinicians via telehealth. Yet, it is unclear if this self-palpation assessment of IRD, when conducted via telehealth, is reliable or valid. PURPOSE: The purpose of this study is to determine test-retest reliability and construct validity of self-palpation assessment of IRD via telehealth. METHODS: A methodological design will be used to test the null hypotheses: (a) there will not be a strong agreement between DRA diagnoses determined by self-palpation measurements of IRD via telehealth instructed by a physical therapist and those determined by ultrasonographic measurements with a κ < 0.6, and (b) there will not be a strong agreement between DRA determined by self-palpation measurements of IRD via telehealth-instructed visit and those determined by a physical therapist using the palpation method with a κ < 0.6. RESULTS: Results are pending and will be included in final abstract submission. CONCLUSION: There is a strong need for reliable methods of assessment with telehealth services. The results of this study will potentially provide physical therapists with a reliable alternative form of assessment of postpartum women through the use of telehealth services.