Evaluation of Rectus Abdominis Muscle Strength and Width of Hernia Defect in Patients Undergoing Incisional Hernia Surgery

Overview

Journal Hernia

Publisher Springer

Date 2023 Jul 13

PMID 37442870

Authors

A J Garcia Moriana

A Sanchez Arteaga

J L Gil Delgado

R Maroto Sanchez

A Feria Madueno

L Tallon Aguilar

J Padillo Ruiz

B Sanudo

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to analyze the strength status of the rectus abdominis muscle in patients with incisional hernia and the relationship between the width of the hernia defect and the strength of the rectus abdominis muscle.

Methods: This is a observational cohort study of patients with medial line incisional hernia (July-October 2022), classified as W2 according to the European Hernia Society (EHS). The data collected were demographic and clinical characteristics related to hernia, and measure of the rectus abdominis muscle strength using an isokinetic dynamometer and a strain gauge. We analyzed the relationship between hernia width and rectus abdominis muscle strength with correlation tests to adjustment by age, sex, BMI, and body composition.

Results: A total of 40 patients (64% female) with a mean age of 57.62 years (SD 11) were enrolled in the study. The mean BMI was 29.18 (SD 5.06), with a mean percentage of fat mass of 37.8% (SD 8.47) and a mean percentage of muscle mass of 60.33% (SD 6.43). The maximum width of the hernia defect was 6.59 cm (SD 1.54). In the male group, the mean bending force moment (ISOK_PT) was 94.01 Nw m (SD 34.58), bending force moment relative to body weight (ISOK_PT_Weight) was 103.32 Nw m (SD 37.48), and peak force (PK_90) was 184.71 N (SD 47.01). In the female group, these values were 58.11 Nw m (SD 29.41), 66.48 Nw m (SD 32.44), and 152.50 N (SD 48.49), respectively. Statistically significant differences were observed in the relationship between the data obtained with the isokinetic dynamometer and sex (p = 0.002), as well as between the data obtained with the isokinetic dynamometer and age (p = 0.006). Patients in the 90th percentile (P90) of rectus abdominis muscle strength also had smaller hernia defect widths (p = 0.048).

Conclusions: In this study, age and sex were identified as the most statistically significant predictor variables for rectus abdominis muscle strength. The width of the hernia defect exhibited a trend towards statistical significance.

Citing Articles

Impact of incisional hernia on abdominal wall strength.

Arteaga A, Delgado J, Madueno A, Tallon Aguilar L, Sanudo B, Padillo Ruiz J BJS Open. 2024; 8(3).

PMID: 38818958 PMC: 11140820. DOI: 10.1093/bjsopen/zrae045.

References

Nachiappan S, Markar S, Karthikesalingam A, Karthikesaligam A, Ziprin P, Faiz O . Prophylactic mesh placement in high-risk patients undergoing elective laparotomy: a systematic review. World J Surg. 2013; 37(8):1861-71. DOI: 10.1007/s00268-013-2046-1. View

Dietz U, Menzel S, Lock J, Wiegering A . The Treatment of Incisional Hernia. Dtsch Arztebl Int. 2018; 115(3):31-37. PMC: 5787661. DOI: 10.3238/arztebl.2018.0031. View

Bosanquet D, Ansell J, Abdelrahman T, Cornish J, Harries R, Stimpson A . Systematic Review and Meta-Regression of Factors Affecting Midline Incisional Hernia Rates: Analysis of 14,618 Patients. PLoS One. 2015; 10(9):e0138745. PMC: 4577082. DOI: 10.1371/journal.pone.0138745. View

Kossler-Ebs J, Grummich K, Jensen K, Huttner F, Muller-Stich B, Seiler C . Incisional Hernia Rates After Laparoscopic or Open Abdominal Surgery-A Systematic Review and Meta-Analysis. World J Surg. 2016; 40(10):2319-30. DOI: 10.1007/s00268-016-3520-3. View

Nassif A, Nagano T, Villela I, Simonetti G, Dias B, Freitas A . INCISIONAL HERNIOPLASTY TECHNIQUES: ANALYSIS AFTER OPEN BARIATRIC SURGERY. Arq Bras Cir Dig. 2020; 33(2):e1517. PMC: 7682152. DOI: 10.1590/0102-672020200002e1517. View

Acar T, Acar N, Sur Y, Kamer E, Atahan K, Genc H . The Effects of Operation Technique on Recurrence of Incisional Hernia Repair. Sisli Etfal Hastan Tıp Bul. 2020; 54(1):23-28. PMC: 7192261. DOI: 10.14744/SEMB.2019.23334. View

Zhang Y, Zhou H, Chai Y, Cao C, Jin K, Hu Z . Laparoscopic versus open incisional and ventral hernia repair: a systematic review and meta-analysis. World J Surg. 2014; 38(9):2233-40. DOI: 10.1007/s00268-014-2578-z. View

Kwak Y, Kim Y . Quality of life and subjective health status according to handgrip strength in the elderly: a cross-sectional study. Aging Ment Health. 2017; 23(1):107-112. DOI: 10.1080/13607863.2017.1387766. View

Suchomel T, Nimphius S, Stone M . The Importance of Muscular Strength in Athletic Performance. Sports Med. 2016; 46(10):1419-49. DOI: 10.1007/s40279-016-0486-0. View

10.

Wang D, Yao J, Zirek Y, Reijnierse E, Maier A . Muscle mass, strength, and physical performance predicting activities of daily living: a meta-analysis. J Cachexia Sarcopenia Muscle. 2019; 11(1):3-25. PMC: 7015244. DOI: 10.1002/jcsm.12502. View

11.

Mentiplay B, Perraton L, Bower K, Adair B, Pua Y, Williams G . Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study. PLoS One. 2015; 10(10):e0140822. PMC: 4624940. DOI: 10.1371/journal.pone.0140822. View

12.

Sha Z, Dai B . The validity of using one force platform to quantify whole-body forces, velocities, and power during a plyometric push-up. BMC Sports Sci Med Rehabil. 2021; 13(1):103. PMC: 8406610. DOI: 10.1186/s13102-021-00330-z. View

13.

Zapparoli F, Riberto M . Isokinetic Evaluation of the Hip Flexor and Extensor Muscles: A Systematic Review. J Sport Rehabil. 2016; 26(6):556-566. DOI: 10.1123/jsr.2016-0036. View

14.

Birisik F, Ekinci M, Bayram S, Sahinkaya T, Ergin O, Ersen A . Isokinetic Evaluation of Knee Strength and Endurance in Hemodialysis Patients Treated with the Transpatellar Tunnel Technique for Bilateral Spontaneous Quadriceps Tendon Ruptures. J Knee Surg. 2020; 35(2):215-221. DOI: 10.1055/s-0040-1715100. View

15.

Santos A, Pavao S, Avila M, Salvini T, Rocha N . Reliability of isokinetic evaluation in passive mode for knee flexors and extensors in healthy children. Braz J Phys Ther. 2013; 17(2):112-20. DOI: 10.1590/S1413-35552012005000074. View

16.

Callaghan M, McCarthy C, Al-Omar A, Oldham J . The reproducibility of multi-joint isokinetic and isometric assessments in a healthy and patient population. Clin Biomech (Bristol). 2000; 15(9):678-83. DOI: 10.1016/s0268-0033(00)00032-2. View

17.

Reyes-Ferrada W, Chirosa-Rios L, Rodriguez-Perea A, Jerez-Mayorga D, Chirosa-Rios I . Isokinetic Trunk Strength in Acute Low Back Pain Patients Compared to Healthy Subjects: A Systematic Review. Int J Environ Res Public Health. 2021; 18(5). PMC: 7967351. DOI: 10.3390/ijerph18052576. View

18.

Symons T, Vandervoort A, Rice C, Overend T, Marsh G . Reliability of isokinetic and isometric knee-extensor force in older women. J Aging Phys Act. 2005; 12(4):525-37. DOI: 10.1123/japa.12.4.525. View

19.

Needle A, McAlister M, Felpel Z, McBride J . Use of an Instrumented Ankle Arthrometer and External Strain Gauge to Assess Ankle Dorsiflexion Motion and Plantarflexor Stiffness. J Am Podiatr Med Assoc. 2020; 110(2). DOI: 10.7547/18-023. View

20.

Rodrigues F, Demeyer H, Hornikx M, Camillo C, Calik-Kutukcu E, Burtin C . Validity and reliability of strain gauge measurement of volitional quadriceps force in patients with COPD. Chron Respir Dis. 2017; 14(3):289-297. PMC: 5720235. DOI: 10.1177/1479972316687210. View