The abdominal wall and exercise in parastomal bulging
Research type
Research Study
Full title
Investigating biomechanical mechanisms of change of the abdominal wall from core exercises in people with a bulge around their stoma
IRAS ID
320324
Contact name
Gill Hubbard
Contact email
Sponsor organisation
University of the Highlands and Islands
Duration of Study in the UK
0 years, 9 months, 11 days
Research summary
Background
To create a stoma, a hole is made in the abdominal wall. This creates an area of weakness and muscle shrinking around the stoma which can change the biomechanical forces and pressure on the abdominal wall. This increases risk of a hernia developing.
Following stoma formation surgery, patients are at high risk (up to 70%) of developing bulging around their stoma. There is a trend towards inactivity for this group with fear of hernia formation.
The use of abdominal exercises are advised as a prevention and management strategy in clinical guidelines (Association of Stoma Care Nurses). However, there remains little evidence for this approach in this population. Yet there is potential for this patient group to strengthen core muscles and lower the risk of a hernia developing, or as a self-management tool for those already living with a bulge/hernia. This preparatory work will examine the physiological changes following 10 weeks of individualised core exercises.
Methods
Preparatory work to establish if the proposed intervention elicits a physiological response. 10 participants will be recruited. A sonographer will record outcomes measures.
We will examine any change to the following measures pre- and post-intervention:
1. Muscle thickness via Ultrasound scan
2. Abdominal wall defect size via Ultrasound scan
3. Patient perception of their bulge via patient diary, and questionnaire
The research team recognise that full statistical analysis will not be appropriate in this instance.
Intervention
Patients will be seen by a specialist physiotherapist who will prescribe exercises based on ability and participant safety. Patients will be asked to perform exercises for 10 weeks. Examples of exercises include Abdominal drawing in manoeuvre; Diagonal Isometric Press; Single leg lift (all in a lying position).
Data
Data will be analysed for indicative change post intervention. Differences in pre- and post-intervention scores will be examined. 95% confidence intervals will be reported to estimate likely effect size.REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
23/YH/0010
Date of REC Opinion
23 Jan 2023
REC opinion
Favourable Opinion