Early structured rehabilitation following open retromuscular incisional hernia repair: a prospective randomized controlled trial

Incisional hernias remain a common postoperative problem for general surgeons. In recent years, early postoperative rehabilitation has gained increasing attention as a potential strategy to enhance recovery following abdominal wall reconstruction. This study aimed to evaluate whether structured early postoperative rehabilitation improves objectively measured abdominal wall and trunk muscle functional recovery after open retromuscular (Rives-Stoppa) incisional hernia repair while maintaining postoperative safety.

Thirty adults undergoing elective open retromuscular (Rives-Stoppa) repair of European Hernia Society W2 incisional hernias were randomized to structured postoperative rehabilitation (n = 15) or standard postoperative care (n = 15). Baseline and approximately 2-month postoperative trunk muscle performance were assessed using Biodex dynamometry. The rehabilitation program consisted of supervised, progressive exercises initiated at postoperative week 3 and delivered according to the standardized study protocol. The primary analyses compared individual patient-level changes in trunk flexor and extensor peak torque between groups at angular velocities of 60°/s and 90°/s using the Mann-Whitney U test. Secondary outcomes included additional dynamometric parameters and postoperative clinical outcomes.