Evaluation of abdominal exercises after stoma surgery: a descriptive study

Abstract

Purpose

To evaluate the feasibility of exercises for the abdominal muscles in patients after colostomy or ileostomy formation on the following parameters: muscle activity, pain, discomfort, and difficulty of performing the exercises.

Materials and methods

Patients with a new stoma were divided into groups based on time after surgery: Early group, 0–2 weeks (n = 12); Intermediate group, 2–6 weeks (n = 15); and Late group, 6–12 weeks (n = 10). During a single individual test session, participants in each group performed a different set of 10–11 abdominal coordination and strengthening exercises for the abdominal muscles. Activity of the abdominal muscles was measured with electromyography. Pain, discomfort, and difficulty were rated for each exercise.

Results

For the Early group, muscle activity reaching a predetermined threshold was measured for half of the participants in a few exercises. In both the Intermediate group and the Late group, muscle activity reaching the onset criteria was measured for all muscles for a high percentage of participants in several exercises. Both strengthening and coordinating exercises were feasible based on low ratings of pain, discomfort, and difficulty.

Conclusions

This study identified feasible exercises that activated the abdominal muscles at different time points after stoma formation. The observations can be used as guidance for the choice of exercises in clinical practice and future research.

Implications for rehabilitation

• The findings of this study can be used in clinical practice as guidance for choice of exercise at different time points after surgery.

• This study identified useful exercises for activating the abdominal muscles in rehabilitation after stoma surgery from two weeks on.

• In the first two postoperative weeks, there was limited involvement of the abdominal muscles with the evaluated exercises.

• Most of the evaluated abdominal exercises were feasible after stoma surgery based on pain, discomfort, and difficulty.

Keywords:

• Surgical stomas
• ostomy
• exercise
• electromyography
• ultrasonography

Acknowledgements

The authors would like to thank the stoma care nurses at Herlev Hospital and Rigshospitalet for assistance with patient recruitment; Team Danmark for help with electromyography equipment; physiotherapist Pia Espensen for input on exercises; and the ultrasound physicians at Herlev Hospital for supervision on ultrasound measurements.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

The study was funded by grants from the Research Foundation of the Capital Region of Denmark; Toyota-Fonden, Denmark (KJ/BG-9092 H); Copenhagen University Hospital, Herlev and Gentofte, Denmark; and Copenhagen University Hospital, Rigshospitalet, Denmark.