Effects of Barre-Based Core Stability With and Without Tupler Technique on Core Strength, Inter Recti Distance, and Pelvic Floor Function Among Diastasis Recti Abdominis Patients

Overview

This study will be a single blind, parallel group randomized controlled trial designed to evaluate the effectiveness of Barre-based core stability training with and without the Tupler Technique in postpartum women with Diastasis Recti Abdominis. A total of 58 eligible participants will be recruited from postpartum care units and randomly assigned in a 1:1 allocation ratio to either an experimental group receiving Barre-based core stability training combined with the Tupler Technique or a control group receiving Barre-based core stability training alone. Both interventions will be delivered under supervised conditions three times per week for 8 weeks, with each session lasting approximately 30-45 minutes. The Barre-based program focuses on controlled low impact movements aimed at improving deep core muscle activation, postural alignment, and neuromuscular coordination. The experimental group will additionally receive the Tupler Technique, which includes abdominal splinting, progressive core strengthening exercises, and neuromuscular re-education targeting approximation of the rectus abdominis muscles and improved abdominal wall function. Outcome measures include inter-recti distance, core strength, and pelvic floor function. Secondary outcomes include postural stability and functional performance. Assessments will be conducted at baseline, mid-intervention (week 4), post-intervention (week 8), and follow-up (week 12) by blinded outcome assessors to minimize bias. The purpose of this trial is to determine whether combining the Tupler Technique with Barre-based core stability training provides superior improvements in abdominal separation, core strength, pelvic floor function, and functional ability compared with Barre-based training alone in postpartum women.

Diastasis Recti Abdominis (DRA) is a postpartum musculoskeletal condition characterized by separation of the rectus abdominis muscles due to weakening of the linea alba, resulting in impaired core stability, reduced pelvic floor function, altered lumbopelvic mechanics, and decreased functional performance. Management is primarily conservative and involves exercise-based rehabilitation targeting abdominal wall integrity and neuromuscular control. Barre-based core stability training is a low impact exercise intervention focusing on postural alignment, controlled movement, and activation of deep core musculature, including the transversus abdominis and pelvic floor muscles. The Tupler Technique is a structured rehabilitation program for DRA that includes abdominal splinting, progressive core strengthening, and neuromuscular re-education to improve rectus abdominis approximation and abdominal wall function. This single blind, parallel group randomized controlled trial will recruit 58 postpartum women diagnosed with DRA. Participants will be randomly allocated using concealed assignment in a 1:1 ratio to either an experimental group receiving Barre-based core stability training combined with the Tupler Technique or a control group receiving Barre-based training alone. Both groups will receive supervised interventions three times per week for 8 weeks, with each session lasting 30-45 minutes. The exercise protocol emphasizes controlled activation of deep core muscles, postural control, and safe functional movement patterns. The experimental group will additionally perform abdominal splinting and structured neuromuscular re-education as part of the Tupler Technique. Outcome measures will include inter-recti distance, core strength, pelvic floor function, postural stability, and functional performance. Assessments will be conducted at baseline, week 4, week 8, and week 12 by blinded outcome assessors. Data will be analyzed to compare within group and between group changes over time, using appropriate statistical methods under an intention-to-treat approach. The study evaluates whether adding the Tupler Technique to Barre-based core stability training provides superior improvements in abdominal separation, core stability, pelvic floor function, postural control, and functional ability in postpartum women with Diastasis Recti Abdominis.