Early rehabilitation of abdominal muscle wall following lower transverse abdominal incision in women: a randomized clinical trial

Abstract

Introduction: historically, the gynaecologist- obstetrician has favoured lower abdominal transverse incisions. For the abdominal muscle, there is a relevant surgical-related muscle loss induced by major surgical trauma after lower transverse incisions as well as fatigue and restricted respiratory movements during the early postoperative days. Objective: this study aimed to assess the impact of inducing rehabilitation program for abdominal muscles very early after lower abdominal transverse incisions. Methodology: a prospective randomized clinical trial that compared 2 groups of 60 participants was conducted. All participants were postoperative women after their 1st cesarean delivery, hysterectomy, and myomectomy. Group A included participants who joined an early specific exercise rehabilitation program for abdominal muscles and postoperative advice. Group B included control volunteers who received the same postoperative care at the hospital and at home as group A. Results: between-groups comparisons revealed a statistically significant increase in rectus abdominis muscle thickness in favor of group A participants. Additionally, postoperative incisional pain was significantly lower among group A participants, suggesting a strong negative correlation between muscle thickness and postoperative pain. Conclusions: in summary, adding early mobilization abdominal exercises for rehabilitation programs was very effective to strengthen abdominal muscles, decrease annoying post operative incisional pain and promote early recovery after lower abdominal surgery in women in resources limited countries.