Authors: (including presenting author): :
Wong SH, Poon HK, Ko CY, Au OL
Affiliation: :
Physiotherapy Department, United Christian Hospital
Keyword 1: :
Parastomal Hernia
Keyword 3: :
Physiotherapy
Keyword 5: :
Colorectal Surgery
Keyword 6: :
Abdominal Strengthening
Introduction: :
Parastomal hernia (PSH) is common after stoma surgery, leading to pain, reduced mobility, and increased risk of emergency surgery. Current clinical evidences recommend structured exercise and abdominal support for PSH prevention. The clinical implication and effectiveness however have not been fully investigated in local public healthcare setting.
Objectives: :
To evaluate the effectiveness of a structured multimodal physiotherapy program for prevention of PSH.
Methodology: :
Patients aged ≤80 years undergone elective colostomy/ileostomy since October 2024 were recruited. A 9-month hybrid mode (face-to-face and tele) physiotherapy program consisting of 6-session being held on week 6, 8, 12, 16, 28, and 36 after operation, focusing on progressive core muscle strengthening and general fitness restoration through education & empowerment was constructed. Program effectiveness was measured by abdominal muscle thickness (assessed via diagnostic ultrasound), 6-Minute Walk Test (6MWT), exercise compliance, and PSH incidence rate.
Result & Outcome: :
By December 2025, 39 subjects were recruited and 11 completed the program. No significant differences were observed in baseline demographical data. Paired data analysis (n=11) comparing the first and final assessments revealed significant improvements in the followings: •Combined internal and external oblique muscles thickness on operative side (mean increase 2.24 mm, p=0.034),
•Transverse abdominis thickness (mean increase 0.5 mm, p=0.035), •6MWT distance (mean increase 59.7 m, p=0.001), •Weekly total core exercise (125 minutes) and total aerobic exercise time (136 minutes) (both p< 0.01), •No case with PSH was reported. Initial findings suggest that this multimodal physiotherapist PSH prevention program effectively mitigates PSH risk and enhances functional recovery. To strengthen the authenticity of these findings and minimize potential bias, a larger subject pool is necessary. Larger sample size will allow a definitive validation of the program’s clinical impact, ensuring it’s scalability and sustainability for the post-surgical care of patients for prevention of PSH after colostomy/ileostomy.
