A Pilot Study Examining Feasibility of Perioperative Rehabilitation for Inguinal Hernia Repair Surgery

• Author / Creator

  Shologan, Anna

• Introduction: Despite the relative simplicity and high frequency of inguinal hernia repair (IHR) surgery, there is little research investigating pre- or post-operative exercise and education in this population. Recommendations regarding perioperative physical activity are inconsistent and largely based upon clinical opinion. We examined feasibility of recruitment and assessment methods for studying perioperative rehabilitation for IHR surgery. Baseline results allow us to better describe the pre-surgical population.
  Methods: A pilot randomized controlled trial (RCT) was conducted. Patients being considered for IHR were referred from a general surgeon in Edmonton, Alberta between February to October 2022. Eligible participants completed online consent forms and surveys regarding demographics, work status, and level of pain and disability. Following this, a baseline performance-based functional assessment was completed by a masked observer, which included a Short Form Functional Capacity Evaluation (FCE) of the trunk and lower extremities.
  Results: From 60 referrals we enrolled 31 participants (recruitment rate 51.67%) with a mean age of 49.4 years awaiting IHR. The primary reason for referrals opting out of the study was inability to take time from work to attend the in person assessment. One participant opted out of the study due to scheduling conflicts after expressing interest but prior to completing the consent form. Two participants did not undergo functional testing after completing the online surveys due to COVID-19 infection and new musculoskeletal injuries experienced before testing. Of those attending the performance-based functional assessment 20 out of 28 participants finished the assessment with no hernia related symptoms. Mean performance on floor-to-waist lifting was 34.5 kg (±10.5), with only 2 participants reporting hernia-related pain. Eleven participants lifted to within 4.5kg of the test ceiling (45kg). The most problematic test for participants was an abdominal muscle endurance test, with 8 participants reporting hernia pain during this activity.
  Conclusion: Adequate number of participants were recruited to our pilot study with a relatively high recruitment rate (51.7%). Most patients awaiting IHR demonstrated excellent functional ability, lifting to maximum capacity with no exacerbation of hernia symptoms. Our pilot RCT methods appear feasible however, changes to the assessment protocol are needed to avoid a potential ceiling effect with performance-based functional testing.

• Subjects / Keywords

  • Rehabilitation
  • Perioperative
  • Inguinal Hernia

• Graduation date

  Spring 2023

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-sdgp-f336

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.