earticle

영어

Symphysis pubis diastasis (SPD) is an uncommon but debilitating musculoskeletal disorder characterized by the pathological separation of the pubic symphysis, frequently associated with pregnancy and childbirth. Although mild cases typically resolve spontaneously, severe or persistent SPD may lead to considerable pain, reduced mobility, and extended functional impairments. This systematic review seeks to assess the efficacy of exercise-based interventions, with a particular focus on physiotherapeutic approaches such as core stabilization and pelvic floor muscle training (PFMT), in the conservative treatment of SPD. In accordance with the PRISMA 2020 guidelines, a comprehensive literature search was performed across PubMed, CINAHL, Cochrane Library, and Scopus for articles published between January 1990 and May 2024. Eligible studies comprised randomized controlled trials (RCTs), cohort studies, and case reports examining exercise therapy for women diagnosed with SPD during or after pregnancy. A total of eight studies met the inclusion criteria. Data extraction and quality assessment were conducted using the PEDro and JBI appraisal tools. The majority of included studies reported significant improvements in pain, functional mobility, and pelvic stability following structured physiotherapy interventions. Core stabilization and PFMT were consistently associated with reductions in pain scores and enhanced postpartum recovery. High-quality RCTs demonstrated the superiority of individualized, supervised exercise interventions compared to standard care. Nevertheless, heterogeneity in exercise protocols, outcome measures, and follow-up durations limited the generalizability of these findings. Exercisebased rehabilitation, particularly targeted core and pelvic floor muscle training, appears to be an effective and safe conservative treatment for SPD. Early initiation and individualized therapy plans may optimize outcomes and prevent chronic dysfunction. Future research should aim to standardize intervention protocols and undertake large-scale, longitudinal studies to reinforce clinical guidelines for postpartum rehabilitation.