To investigate the effect of preoperative graduated abdominal exercises and Russian stimulation on the abdominal muscles' strength after abdominoplasty

To investigate the effect of preoperative graduated abdominal exercises and Russian stimulation on the abdominal muscles' strength after abdominoplasty. Sixty patients will undergo abdominoplasty, their age ranged from 20 to 45 years, they were randomly distributed into four equal groups. The ultrasonography was used to evaluate abdominal muscle thickness as indicator for muscle strength at 4 occasions, initial assessment, pre-operative assessment, 2 months post-operative assessment, and finally 4 months post-operative assessment). For study group (A); received graduated abdominal exercises, group (B); received Russian stimulation on abdominal muscles, group (c); received combination between graduated abdominal exercises and Russian stimulation on abdominal muscles, the study groups received the treatment protocol for 30 min., 3 times per week for 6 weeks preoperatively for control group (D); were instructed to presume in normal activities of daily living preoperatively

Inclusion Criteria:

• Age range between 20-45 years. All patients desire an elective surgical repair.
• All patients were diagnosed with ventral hernia based on surgeon assessment.
• All patients will participate in the study.
• All patients enrolled to the study will have their informed consent.
• All patients are able to act in abdominal training program.
• All patients are able to follow orders during testing and training times.

Exclusion Criteria:

• A strangulated hernia.
• History of surgical interference (abdominal surgery) less than one year.
• Liver cirrhosis with or without ascites.
• Hip or spine deformities or contractures.
• Bowel obstruction, peritonitis, or perforation.
• Local or systemic infection.
• Patient is pregnant or intended to become pregnant during this period.
• Patient has indication for urgent surgery determinate by surgeon.

Blinding process to participants and care providers was impossible due to the nature of intervention therapy. Data were analyzed by an impartial statistician (outcomes assessor), referring to each arm with an encoded name: groups (A) & (B) & (C) ( three study groups ) and group (D) ( control group )