Functional Status after Ventral Hernia Repair: Longitudinal Trends and the Limits of Improvement

The impact of ventral hernias on physical function remains unclear. This study evaluated the association between hernia repair and patient functional status over time.

As part of the "Pilot Trial of Abdominal Core Rehabilitation To Improve Outcomes After Ventral Hernia Repair" (NCT05142618; 12/02/2021), we analyzed prospective data between April 2022 and August 2024. Patients completed timed up and go (TUG) and 5 times sit-to-stand (5×STS) tests preoperatively and at 4 weeks, 10 weeks, 6 months, and 1 year postoperatively. Generalized estimating equations modeling and quadratic trend analyses assessed changes in functional test scores over time.

Among 127 participants (mean age 51 years, mean BMI 33.07 kg/m 2 , 61% male, mean hernia width 7.02 cm [SD 6.91 cm]), preoperative mean TUG was 8.48 seconds (SD 2.22 seconds) and 5×STS was 14.34 seconds (SD 5.25 seconds). Functional test scores worsened at 4 weeks postsurgery (TUG estimate 0.94 [SE 0.35], p = 0.007; 5×STS estimate 1.81 [SE 0.73], p = 0.014). Thereafter, only 5×STS demonstrated significant improvement at 10 weeks (estimate -1.13 [SE 0.35], p = 0.001), 6 months (estimate -1.32 [SE 0.34], p < 0.001), and 1 year (estimate -1.50 [SE 0.31], p < 0.001). 5×STS's rate of improvement slowed over time, indicating a plateau effect (linear term estimate -0.121 [0.04], p = 0.002; quadratic term estimate 0.002 [SE 0.0007], p = 0.045).

Physical function testing provides a practical means to assess longitudinal functional status after ventral hernia repair. In this study, 5×STS performance had early decline, progressive recovery, and plateau by 1 year after surgery. TUG showed little long-term change. These findings establish 5×STS as a valuable tool for tracking functional status trajectories and highlight the need to further evaluate rehabilitation strategies to optimize patient outcomes.