{"title":"Implementation of a prehabilitation program before abdominal wall surgery: a pilot and feasibility study.","authors":"Gaëtan-Romain Joliat, Sonia Krouk, Eddy Cotte, Guillaume Passot","doi":"10.1007/s10029-025-03325-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Prehabilitation in abdominal wall surgery (AWS) might improve postoperative outcomes, but current data are scant. A prehabilitation program before AWS, including specific hypopressive abdominal exercises, was recently implemented in our department. This study aimed to present the characteristics of the implemented program and to assess the adherence rate to hypopressive abdominal exercises.</p><p><strong>Methods: </strong>A retrospective study of all consecutive patients included in the pathway from October 2021 to October 2024 was performed. The multimodal prehabilitation program included nutritional support, physical activities (cardiorespiratory training, muscular strengthening, hypopressive abdominal exercises, and relaxation), and psychological support. Adherence rate was defined as the number of patients who performed the proposed abdominal exercises divided by the total number of included patients.</p><p><strong>Results: </strong>A total of 103 patients were included (43% women, median age: 64, IQR 55-72, median body-mass index: 29 kg/m<sup>2</sup>, IQR 26-33). Most of them had a midline hernia (n = 79, 77%) and underwent a retromuscular mesh repair (n = 93, 90%). Ninety-six patients were adherent to the hypopressive abdominal exercises (adherence rate: 93%). Obese patients had a significantly lower adherence rate to hypopressive abdominal exercises than non-obese patients (29/34 = 85% vs. 67/69 = 97%, p = 0.025). Median length of hospital stay was 3 days (IQR 2-5) and postoperative complications occurred in 29 patients (28%).</p><p><strong>Conclusion: </strong>The implementation of a prehabilitation program in AWS was feasible. Moreover, adherence to the hypopressive abdominal exercises was high. Obese patients might require more attention to improve their adherence to the program.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"138"},"PeriodicalIF":2.6000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03325-8","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Prehabilitation in abdominal wall surgery (AWS) might improve postoperative outcomes, but current data are scant. A prehabilitation program before AWS, including specific hypopressive abdominal exercises, was recently implemented in our department. This study aimed to present the characteristics of the implemented program and to assess the adherence rate to hypopressive abdominal exercises.
Methods: A retrospective study of all consecutive patients included in the pathway from October 2021 to October 2024 was performed. The multimodal prehabilitation program included nutritional support, physical activities (cardiorespiratory training, muscular strengthening, hypopressive abdominal exercises, and relaxation), and psychological support. Adherence rate was defined as the number of patients who performed the proposed abdominal exercises divided by the total number of included patients.
Results: A total of 103 patients were included (43% women, median age: 64, IQR 55-72, median body-mass index: 29 kg/m2, IQR 26-33). Most of them had a midline hernia (n = 79, 77%) and underwent a retromuscular mesh repair (n = 93, 90%). Ninety-six patients were adherent to the hypopressive abdominal exercises (adherence rate: 93%). Obese patients had a significantly lower adherence rate to hypopressive abdominal exercises than non-obese patients (29/34 = 85% vs. 67/69 = 97%, p = 0.025). Median length of hospital stay was 3 days (IQR 2-5) and postoperative complications occurred in 29 patients (28%).
Conclusion: The implementation of a prehabilitation program in AWS was feasible. Moreover, adherence to the hypopressive abdominal exercises was high. Obese patients might require more attention to improve their adherence to the program.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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