Postoperative activity restrictions: any evidence?
OBJECTIVE
Because of a widespread but untested belief that increased intra-abdominal pressure contributes to pelvic floor disorders, physicians commonly restrict various activities postoperatively. Our aim was to describe intra-abdominal pressures during common physical activities.


METHODS
Thirty women of wide age and weight ranges who were not undergoing treatment for pelvic floor disorders performed 3 repetitions of various activities while intra-abdominal pressures (baseline and maximal) were approximated via microtip rectal catheters. We calculated median peak and net pressures (centimeters of H(2)O). We assessed correlations between abdominal pressures and body mass index, abdominal circumference, and grip strength (a proxy for overall strength). P < .025 was considered significant.


RESULTS
Median peak abdominal pressures ranged from 48 (lifting 8 lb from a counter) to 150 (lifting 35 lb from the floor), with much variation. Many activities did not raise the intra-abdominal pressure more than simply getting out of a chair, including lifting 8, 13, and 20 lb from a counter, lifting 8 or 13 lb from the floor, climbing stairs, walking briskly, or doing abdominal crunches. Body mass index and abdominal circumference each correlated positively with peak, but not net, pressures. Age and grip strength were not associated with abdominal pressure.


CONCLUSIONS
Some activities commonly restricted postoperatively have no greater effect on intra-abdominal pressures than unavoidable activities like rising from a chair. How lifting is done impacts intra-abdominal pressure. Many current postoperative guidelines are needlessly restrictive. Further research is needed to determine whether increased intra-abdominal pressure truly promotes pelvic floor disorders.


METHODS
III.
Weir
Larissa F
LF
Department of Obstetrics and Gynecology, San Antonio Uniformed Services Health Education Consortium, Texas, USA.
Nygaard
Ingrid E
IE
Wilken
Jason
J
Brandt
Debra
D
Janz
Kathleen F
KF
D000005:Abdomen; D000328:Adult; D005260:Female; D006801:Humans; D009043:Motor Activity / Q000502:physiology*; D011182:Postoperative Care; D011312:Pressure; D014891:Weight Lifting