Effect of Preoperative Abdominal Training on Abdominal Muscles Strength Outcomes after Ventral Hernia Repair

Abstract

Background: Hernias are caused by a weakness in the abdominal wall along with increased intra-abdominal pressure and poor wound healing. Ventral (incisional) hernias usually result from a weakness in the abdominal wall after abdominal surgery, especially in the obese patient. Aim of Study:To investigate the effect of pre-operative abdominal training on abdominal muscle strength outcomes after ventral hernia repair by using isokinetic dynamometer as a method of evaluation.Methods: 30 patients their age ranged between 20-45 years with ventral hernia, they were directed to operative hernia repair. The patients were randomly divided into two groups: Group (A) (control group) and Group (B) (study group). Isokinetic dynamometer was used to evaluate abdominal muscle strength at 3 occasions, first (initial assessment), second (pre-operative assessment), and third (6 months postoperative assessment). For Group (A) (control group); they were instructed to presume their activities of daily living preoperatively. For Group (B) (study group); they received selective abdominal training program for 30min. 3 times per week for 6 weeks pre-operatively.Results: The result showed that there was a significant increase in abdominal muscle strength post-operatively in study (abdominal training) group compared to control group.Conclusion: It was concluded that pre operative abdominal muscle training was effective for strengthening abdominal muscles after ventral hernia repair.

Physical activity recommendations pre and post abdominal wall reconstruction: a scoping review of the evidence

“…[21] Although the primary outcome is not explicitly stated, the SG was shown to have experienced a significantly greater change in abdominal wall muscle strength postoperatively compared to the CG (45.89±9.53Nm preoperative to 41.3±0.89Nm postoperative (p=0.0001) versus 33.97±6.78Nm preoperative to 30.05±8.94Nm postoperative (p=0.002)) respectively. [21] Pezeshk et al is a retrospective cohort study of 275 abdominal wall hernia patients of whom 137 were prescribed a regimen of abdominal wall flexibility and strengthening exercises to be done both preoperatively as well as postoperatively. [16] The exact nature of the outcome measures and follow-up protocol was inadequately described however patients were followed up longitudinally and the duration from surgery until recurrence was recorded.…”

“…[15] Ahmed et al is a RCT of 30 patients with abdominal wall hernias of whom a fifteen patient SG underwent a 30-minutes per session, three sessions per week, six week preoperative flexibility and abdominal wall muscle strengthening program. [21] The peak abdominal muscle torque of all 30 participants was measured at initial assessment and then again preoperatively and six months postoperatively. [21] Although the primary outcome is not explicitly stated, the SG was shown to have experienced a significantly greater change in abdominal wall muscle strength postoperatively compared to the CG (45.89±9.53Nm preoperative to 41.3±0.89Nm postoperative (p=0.0001) versus 33.97±6.78Nm preoperative to 30.05±8.94Nm postoperative (p=0.002)) respectively.…”

“…[21] The peak abdominal muscle torque of all 30 participants was measured at initial assessment and then again preoperatively and six months postoperatively. [21] Although the primary outcome is not explicitly stated, the SG was shown to have experienced a significantly greater change in abdominal wall muscle strength postoperatively compared to the CG (45.89±9.53Nm preoperative to 41.3±0.89Nm postoperative (p=0.0001) versus 33.97±6.78Nm preoperative to 30.05±8.94Nm postoperative (p=0.002)) respectively. [21] Pezeshk et al is a retrospective cohort study of 275 abdominal wall hernia patients of whom 137 were prescribed a regimen of abdominal wall flexibility and strengthening exercises to be done both preoperatively as well as postoperatively.…”