Implementation of a prehabilitation program before abdominal wall surgery: a pilot and feasibility study

Area of Science:

• Surgical innovation
• Patient recovery optimization
• Rehabilitation science

Background:

• Prehabilitation may enhance postoperative outcomes in abdominal wall surgery (AWS), but data are limited.
• A multimodal prehabilitation program, including hypopressive abdominal exercises, was implemented in a clinical setting.
• Assessing program feasibility and adherence is crucial for optimizing patient care.

Purpose of the Study:

• To describe the characteristics of a novel prehabilitation program for AWS.
• To evaluate the adherence rate to hypopressive abdominal exercises within this program.
• To identify factors influencing adherence, particularly in obese patients.

Main Methods:

• Retrospective analysis of 103 consecutive patients undergoing AWS from October 2021 to October 2024.
• The prehabilitation program encompassed nutritional, physical (including hypopressive exercises), and psychological support.
• Adherence was defined as the proportion of patients performing the prescribed hypopressive exercises.

Main Results:

• High adherence to hypopressive abdominal exercises was observed in 93% of patients (96/103).
• Midline hernias and retromuscular mesh repair were common surgical indications.
• Obese patients exhibited significantly lower adherence (85%) compared to non-obese patients (97%, p=0.025).

Conclusions:

• Implementation of a prehabilitation program for AWS is feasible and demonstrates high patient adherence.
• Hypopressive abdominal exercises are well-tolerated and highly adhered to by most patients.
• Targeted strategies may be needed to enhance adherence in obese patients undergoing AWS.