Background and objective: Prior studies have reported an activation of abdominal muscles during hypopressive exercises in women with pelvic floor disfunction. However, no previous research analyzed the effects of hypopressive exercise on abdominal muscles in healthy populations to understand the normal biomechanics of this area. The aim of this study was to examine the thickness of abdominal muscles at rest and during hypopressive exercise in supine and standing positions with ultrasound imaging in healthy adults. Methods: A cross-sectional study was carried out in 99 healthy university students. The thickness of the abdominal muscles at rest and during hypopressive exercise was assessed with ultrasound imaging in supine and standing positions. Results: During hypopressive exercise, there was a significant increase in the muscle thickness of transversus abdominis (p < 0.001) and internal oblique (p < 0.001) in supine and standing positions. External oblique only increased its thickness significantly in the standing position (p < 0.001) and rectus abdominis did not change during the hypopressive exercise in any position (p > 0.05). In conclusion, hypopressive exercises seem to increase the thickness of the deepest and most stabilized muscles such as transversus abdominis and internal oblique. Conclusions: These findings should be considered for future interventions with hypopressive exercises in healthy subjects.

This study analyzes the effects of hypopressive exercises on the abdominal thickness of healthy subjects and compares the performance between women and men. We conducted a transversal observational study in 98 subjects (63% women). The muscle thickness is analyzed in transversus abdominis, internal oblique, external oblique, and rectus abdominis with ultrasound imaging at rest and during the hypopressive exercise (HE) in supine and standing position. Comparisons between rest and hypopressive exercise are carried out in the two different positions and between women and men. In the supine position, there is a significant activation of the transversus abdominis and internal oblique during hypopressive exercise (p < 0.001), and it is similar in both sexes, the external oblique is only activated significantly by men (p < 0.001) and rectus abdominis had no significant activation (p > 0.05). Our results show that standing transversus abdominis and external oblique significantly increased their thickness during HE with higher effects in men. Internal oblique also increased significantly, but with higher effects in women, and rectus abdominis had no significant increase. Men had similar effects to women during HE, with an activation of the deepest abdominal muscles. The unequal anatomy and the position could explain the different results obtained between the sexes.

Background: Diastasis recti abdominis (DRA) is the separation of the rectus abdominis muscles along the linea alba, often occurring during pregnancy due to hormonal and mechanical changes. While DRA usually resolves post-childbirth, some women experience persistent issues. Exercise may help reduce the inter-rectus distance, though more research is needed. Objectives: Analyze the immediate and long-term effects of hypopressive and conventional abdominal exercises on inter-rectus distance (IRD) in postpartum women, focusing on parity differences. Methods: Twenty-eight women who met specific inclusion criteria were randomly assigned to either the hypopressive group (n = 14) or the conventional group (n = 14). The exercise programs for both groups lasted 6 weeks. Ultrasound measurements were taken of the IRD at two locations above the umbilicus, 2 cm (AB2) and 5 cm (AB5), before and after exercise programs. Results: The IRD decreased after both exercise programs compared to baseline measurements in AB2 (mean difference: 3.06 mm, 95% CI: 1.06 to 5.05) and in AB5 (mean difference: 2.88 mm, 95% CI: 1.59 to 4.17), confirming the long-term effect of exercise. No differences were found between the application of the conventional exercise program or the hypopressive exercises, indicating that both had a similar positive effect. Regarding the immediate effect, after the performance of both programs, the IRD was greater during rest compared to abdominal contraction. This effect was more pronounced at AB5 location (mean difference: 1.00mm, 95% CI: 0.97 to 1.89). Conventional exercises result in a reduction during resting condition (mean difference: 4.52mm, 95% CI: 2.62 to 6.79), whereas with hypopressive exercises, the reduction occurs during muscle contraction (mean difference: 3.43mm, 95% CI: 1.21 to 5.65). With regard to parity, multiparous women benefit most from the application of exercise programs. Conclusion: A reduction in IRD has been achieved with the implementation of both exercise programs in postpartum women, with multiparous women benefiting the most. Specifically, at 5 cm above umbilicus, conventional exercises result in a reduction during the rest condition, whereas with hypopressive exercises, the reduction occurs during muscle contraction. Trial registration: Clinical trial registration: NCT05439668.

(1) Background: Manual lymphatic drainage (MLD), included within the complex decongestive therapy, as a therapy for the treatment of lymphedema has raised controversy about its benefits for lymphedema after breast cancer. The aim of this research is to test the effects of MLD on lymphedema after breast cancer during the treatment maintenance phase. (2) Methods: A randomized, single-blinded, controlled crossover trial was conducted to analyze the effects of a manual lymphatic drainage intervention compared to a control group without MLD intervention for the treatment of lymphedema. Arm volume measured by circumference measurement, subcutaneous tissue thickness measured by ultrasound, and the sensation of pain, heaviness, and swelling were evaluated as outcome measures. (3) Results: For the control group, an increase in volume was found in some of the circumference and subcutaneous tissue thickness measurements, in addition to a worsening of arm pain, swelling and heaviness. (4) Conclusion: The absence of treatment based on MLD in lymphedema after breast cancer worsens volume measurements, as well as arm heaviness. Therefore, it would be advisable to carry out this type of therapy as part of the maintenance treatment for lymphedema in breast cancer.