Diastasis recti (DRA) is characterized by the separation of the abdominal muscles due to the widening of the linea alba, leading to abdominal bulging and functional impairments. This condition is associated with abdominal muscle weakness, lower back pain, and pelvic floor dysfunctions, which can negatively impact women's quality of life. Conservative treatment is the first-choice approach, and physical therapy plays a fundamental role in this process. In this context, the Pilates Method has been suggested as an effective strategy for strengthening the abdominal muscles; however, there are still few studies investigating its effects on women with DRA.

To evaluate the effects of the Pilates Method on abdominal muscle function in women with DRA.

This is a randomized, longitudinal, and quantitative clinical trial. The study included 44 women over 18 years old, primiparous or multiparous, diagnosed with DRA (inter-rectus distance greater than 20mm). Participants were randomly divided into two groups: the Pilates Group (n = 22), which followed a Pilates exercise protocol twice a week for 12 weeks, with 30-minute supervised sessions; and the Control Group (n = 22), which did not receive any intervention during this period. Muscle function was assessed using the front plank and side plank tests (right and left), measuring the maximum holding time. Statistical analysis was performed using SPSS software, employing the repeated measures ANOVA test for group comparisons and Tukey's post-hoc test. The significance level adopted was 5%.

Both groups had similar characteristics before the intervention. After 12 weeks, a group-time interaction was observed in the right side plank [F(1,38) = 9.29; p = 0.004] and left side plank [F(1,38) = 9.52; p = 0.004] measurements. The post-hoc test showed an increase in plank holding time only in the Pilates Group, with a significant difference between groups after the intervention (p < 0.001). No statistically significant differences were observed in the front plank test.

The findings demonstrate that the Pilates Method significantly improves abdominal muscle function in women with DRA. The increased plank holding time indicates core muscle strengthening, which may contribute to improved lumbopelvic stability and reduced symptoms associated with DRA.

The results suggest that the Pilates Method can be incorporated as a therapeutic strategy for the rehabilitation of women with DRA, promoting functional improvement. However, the study did not assess the reduction of the inter-rectus distance, which limits the understanding of the structural effect of the intervention. Future research should include this evaluation for a more comprehensive approach to the effectiveness of Pilates in DRA.