Predictive Factors in the Outcome of Surgical Repair of Abdominal Rectus Diastasis

Abstract

Background:The aim of this study was to define the indicators predicting improved abdominal wall function after surgical repair of abdominal rectus diastasis (ARD). Preoperative subjective assessment quantified by the validated Ventral Hernia Pain Questionnaire (VHPQ) was related to relative postoperative functional improvement in abdominal muscle strength.Methods:Fifty-seven patients undergoing surgery for ARD completed the VHPQ before surgery. Preoperative pain assessment results were compared with the relative improvement in muscle strength measured with the BioDex system 4.Results:There was a correlation between the relative improvement in muscle strength measured by the BioDex System 4 for flexion at 30 degrees (P = 0.046) and 60 degrees per second (P = 0.004) and the preoperative question, “Do you find it painful to sit for more than 30 minutes?” There was also a correlation between BioDex improvement for flexion at 30 degrees (P = 0.022) and for isometric work load (P = 0.038) and the preoperative question, “Has abdominal pain limited your ability to perform sports activities?” The VHPQ responses also formed a pattern with a fairly good correlation between other BioDex modalities (with the exception of extension at 60 degrees per second) and the response to the question regarding complaints when performing sports. Postoperative visual analog scale ratings of abdominal wall stability correlated to the questions regarding complaints when sitting (P = 0.040) and standing (P = 0.047). No other correlation was seen.Conclusion:VHPQ ratings concerning pain while being seated for more than 30 minutes and pain limiting the ability to perform sports are promising indicators in the identification of patients likely to benefit from surgical correction of their ARD.

One-year outcome after repair of giant incisional hernia using synthetic mesh or full-thickness skin graft: a randomised controlled trial

“…Patients in both groups underwent computerised tomography scan (CT scan) of the abdominal wall. An objective way to measure the effect of a giant hernia and its repair on daily activities is to assess abdominal wall muscle strength using the Biodex system™ (Biodex Corp. Shirley, NY, USA) [ 21 ]. The Biodex system has been validated and shown to be reliable in patients with giant ventral hernia as well as abdominal rectus diastasis [ 22 , 23 ].…”

Operative correction of abdominal rectus diastasis (ARD) reduces pain and improves abdominal wall muscle strength: A randomized, prospective trial comparing retromuscular mesh repair to double-row, self-retaining sutures

“…A comparison between outcome and predictive factors estimated by VHPQ has been published recently showing that complaints when sitting in a low chair and performing sport is predictive for operative outcome regardless of operative method used. 33 Since the present study was power calculated for the main outcome recurrence, interpretations of the secondary outcomes must be done with caution. There was no calculation of power for any of the secondary outcomes prior to the operation and thus not for the patients receiving physical training only.…”

The Triangular Technique for Abdominal Myofascial Plication

“…Although rectus diastasis is considered a cosmetic disfigurement, its repair improves the functions of the abdominal muscles and the quality of life of many patients [14]. This is because the tight lateral abdominal wall muscles after repair become more efficient as spine stabilizers and improve the chronic pain of the lower back [15].…”