Does it work? comparing short-term physical performance following treatment of diastasis recti using army physical fitness test outcomes.

PURPOSE: Diastasis recti (DR) may impair abdominal wall function. The functional impact of operative repair remains incompletely understood. We aim to describe the effect of surgical intervention using objective physical performance outcomes. METHODS: A retrospective cohort study was performed between January 2012 to December 2023 using data from the Medical Assessment and Readiness System (MARS). Cohorts undergoing operative and non-operative treatment of DR were compared. A subset analysis was performed for patients undergoing repair who also received physical therapy. Statistical analyses were descriptive and exploratory to observe fitness patterns after different management pathways. RESULTS: 208 patients met inclusion criteria. The nonoperative group had lower baseline Army Physical Fitness Test (APFT) performance than the operative groups. Mean total APFT score changed from 214.6 to 220.9 in the repair-only group (+6.3 points at the second post-index assessment), 214.8 to 202.6 in the repair plus physical therapy group (-12.2 points), and from 201.4 to 186.6 in the nonoperative group (-14.8 points). Between-group differences at the second post-index assessment were not statistically significant for push-ups (p=0.88), sit-ups (p=0.88), run time (p=0.77), or total APFT score (p=0.98). CONCLUSIONS: In this selected cohort involving a uniquely active population consisting of military soldiers, descriptive summaries did not show clear unadjusted separation in short-term physical fitness test performance across management groups. Due to limitations of this study, these findings should be viewed as hypothesis-generating occupational observations rather than as evidence of comparative effectiveness, equivalence, or lack of benefit from operative repair.