rectus-abdominusThe two new NIH awards earned inside Ohio State’s Center for Abdominal Core Health — the world’s first multidisciplinary center of its kind — are are among the first using the conceptual model of abdominal core health as a new field and build on the understanding that core health can play a direct role in hernia development and recovery.

Ventral hernia and physical therapy study

The first Ohio State study — one of the few R01-funded studies ever in hernia/abdominal core health — evaluates the benefit of a formal abdominal core surgery rehabilitation protocol after ventral hernia repair.

Ventral hernia repair is one of the most common operations performed today, and it involves very dynamic parts of the abdominal core musculature, just like orthopedic surgery. However, unlike orthopedic surgery, no one has definitively confirmed the benefit of physical therapy in this group of patients. Unfortunately, the failure rate of these repairs ranges from 24-43% due to reinjury, other diseases or a poorly maintained abdominal core. In an effort to understand and mitigate this high failure rate, the study will quantify the effects of abdominal core rehabilitation through physical therapy starting with a pilot trial focused on how to best rehabilitate the core musculature post-surgery.

The protocol calls for patients to undergo 10 weeks of rehabilitation after the hernia repair surgery, targeting abdominal core function through progressive muscle retraining and strengthening and patient-specific posture and body mechanics education. Physical performance tests such as the established Five Times Sit-to-Stand, in which the time it takes a patient to stand is timed, and the Quiet Unstable Sitting Test, which tests the ability of a patient to self-stabilize, will act as measurements of patient recovery. These measurements will then be compared to patients in a control group, who’ll be given the current standard-of-care postoperative precautions.

This R01 relies on a relatively new ‘multi-PI’ mechanism in which multiple principal investigators (PIs) can efficiently collaborate and have equal ownership and responsibility for the grant. Leveraging the interprofessional research capabilities available at Ohio State, in this case between the College of Medicine and rehabilitation specialists, are:

Aging hernia patient study

Older patients have unique needs and are at higher risk of poor outcomes after most surgical procedures. Adults over 65 make up one-third of hernia repairs in the United States, with the numbers continuing to increase. This second Ohio State study is intended to characterize and improve outcomes for older ventral hernia patients by better understanding the role of targeted abdominal wall physical therapy on their post-operative outcomes and especially on post-operative function.

To gain a holistic view of the older hernia patient, the research combines data analysis of a national hernia-specific database along with functional outcomes and qualitative patient interviews. It’s funded by an R03 through the NIH’s National Institute on Aging known as a GEMSSTAR (Grants for Early Medical/Surgical Specialists’ Transition to Aging Research), which is designed specifically for faculty who are hoping to become aging researchers. The lead investigator is Courtney Collins, MD, a general surgeon and general surgery and abdominal wall reconstruction specialist with a particular interest in improving care for older surgical patients.

Please visit the Center for Abdominal Core Health to learn more about Ohio State’s innovative approach to abdominal core health and its significant effect on the overall body, with careful consideration of the relationships between the abdominal wall, diaphragm, pelvic floor and even the lower back on multiple diseases and conditions.