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Swedenhammar E, Wahlström O, Brandt JD, Strigård K, Häger C, Stark B, Nyberg A. Reliability and validity of surface EMG assessments combined with isometric muscle strength testing in patients with abdominal rectus diastasis and asymptomatic controls. Hernia 2024:10.1007/s10029-024-03076-y. [PMID: 38850377 DOI: 10.1007/s10029-024-03076-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/19/2024] [Indexed: 06/10/2024]
Abstract
PURPOSE Patients with abdominal rectus diastasis (ARD) may have muscular functional impairments, but clinics lack appropriate objective assessment tools. The aim was to establish the relative and absolute reliability, and convergent validity, of muscular activity using Surface Electromyography (SEMG) during isometric abdominal muscle strength testing in patients with ARD and controls without ARD. METHODS Twenty-six patients with ARD were matched for age, sex and BMI with controls without ARD. Participants were tested twice during isometric muscular contractions using SEMG located on six abdominal sites. Mean amplitude, fatigue, and recruitment order were analyzed. Relative reliability was evaluated with Intraclass Correlation Coefficients (ICC), while absolute reliability was estimated by calculating the Standard Error of Measurement and Minimal Detectable Change. Convergent validity was addressed in relation to participant characteristics, functional ability, and symptoms. RESULTS Mean SEMG amplitude for all abdominal wall muscle contractions showed moderate to excellent relative test-retest reliability, with ICC values ranging from 0.46 to 0.97. In contrast, fatigue and recruitment order displayed poor to moderate relative reliability in both groups. Absolute reliability measures were generally high. A moderate to high convergent validity (ARD: rho-value 0.41-0.70; Controls: rho-value 0.41-0.75) was observed for mean amplitude in relation to a functional sit-to-stand test, abdominal circumference, BMI, back pain, and quality-of-life. CONCLUSIONS The results of applying SEMG during isometric abdominal muscle support practicing the method in clinics, although additional development is needed with further standardization and more functional testing. Furthermore, the method demonstrates construct validity in patients with ARD and in age- and sex-matched controls.
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Affiliation(s)
- E Swedenhammar
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
| | - O Wahlström
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - J D Brandt
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - K Strigård
- Department of Surgical and Perioperative Sciences. Units: Surgery, Umeå University, Umeå, Sweden
| | - C Häger
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - B Stark
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - A Nyberg
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Berkane Y, Saget F, Lupon E, Mocquard C, Pluvy I, Watier E, Lellouch AG, Duisit J, Chaput B, Bertheuil N. Abdominoplasty and Lower Body Lift Surgery Improves the Quality of Life after Massive Weight Loss: A Prospective Multicenter Study. Plast Reconstr Surg 2024; 153:1101e-1110e. [PMID: 37189244 DOI: 10.1097/prs.0000000000010683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study was conducted to assess the impact of abdominoplasty and lower body lift surgery following massive weight loss on both the general quality of life and the sexual life of patients. METHODS The authors performed a multicenter prospective study on the quality of life after massive weight loss using three scoring questionnaires: The Short-Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of Life Questionnaire. Seventy-two patients who underwent lower body lift and 57 patients who underwent abdominoplasty in three centers with preoperative and postoperative evaluation were included. RESULTS The mean age of the patients was 43.2 ± 13.2 years. All categories of the Medical Outcomes Study Short-Form 36 Health Status Survey questionnaire were statistically significant at 6 months, and all categories except health change were significantly improved at 12 months postoperatively. Overall, the Moorehead-Ardelt questionnaire showed a higher quality of life in general (1.78 ± 0.92 and 1.64 ± 1.03 at 6 and 12 months, respectively) and in all domains (ie, self-esteem, physical activity, social relationships, work performance, and sexual activity). Interestingly, global sexual activity improved at 6 months but not at 12 months. Some domains of sexual life improved at 6 months (ie, desire, arousal, lubrication, satisfaction), but only desire remained improved at 12 months. CONCLUSIONS Abdominoplasty and lower body lift improve the quality of life of patients after massive weight loss and the sexual quality of life. This should be an additional valid reason for promoting reconstructive surgery for massive weight loss patients. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Affiliation(s)
- Yanis Berkane
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston
- Harvard Medical School
| | - François Saget
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Elise Lupon
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Nice, Côte d'Azur University
| | - Camille Mocquard
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- INSERM U1236, University of Rennes 1
- SITI Laboratory, Rennes University Hospital
| | - Isabelle Pluvy
- Department of Plastic, Reconstructive, and Aesthetic Surgery, CHU de Besancon, Franche-Comté University
| | - Eric Watier
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital, and Shriners Children Boston
- Harvard Medical School
| | - Jérôme Duisit
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
| | - Benoit Chaput
- Department of Plastic, Reconstructive, and Aesthetic Surgery, Rangueil Hospital, Paul Sabatier University
| | - Nicolas Bertheuil
- From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Hôpital Sud
- INSERM U1236, University of Rennes 1
- SITI Laboratory, Rennes University Hospital
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Pehlke B, Oliveira F, Varnava C, Nehls F, Wiebringhaus P, Kueckelhaus M, Hirsch T, Dermietzel AF. Psychological well-being as a motive for and result of post-bariatric body contouring procedures. Obes Sci Pract 2024; 10:e719. [PMID: 38263992 PMCID: PMC10804339 DOI: 10.1002/osp4.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/27/2023] [Accepted: 10/12/2023] [Indexed: 01/25/2024] Open
Abstract
Objective This study investigates whether psychological well-being in post-bariatric patients seeking body contouring procedures differs from those who do not seek body contouring procedures, those who have already undergone body contouring procedures, and those who are unsure about body contouring procedures. Methods An anonymous, nonrandomized, cross-sectional survey study was designed. Psychological well-being of four groups of post-bariatric-patients (undergone body contouring procedures, seeking body contouring procedures, not seeking body contouring procedures, unsure about body contouring procedures) were compared. Results A total of 345 patients were included in this study. No significant difference between patients seeking body contouring procedures and those not seeking body contouring procedures was found with regard to depressive symptoms, self-esteem, and body image. Patients who had already undergone body contouring procedures scored lower on depressive symptoms (p = 0.035) and reported feeling more attractive (p < 0.001) and less insecure (p = 0.030) than patients who had not yet undergone body contouring procedures but sought it. Satisfaction with the result of the body contouring procedures was associated with lower depression levels (p < 0.001), higher self-esteem (p < 0.001) and a more positive body-image (p < 0.001). Conclusions Depressive symptoms or low self-esteem are not motivational factors for post-bariatric patients to seek body contouring procedures. Body contouring procedures are associated with improvement in psychological well-being in post-bariatric patients. Patients' satisfaction with the result of the body contouring procedures is significantly associated with positive psychological well-being.
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Affiliation(s)
- Britta Pehlke
- Division for Plastic SurgeryDepartment of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MuensterMuensterGermany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand SurgeryFachklinik HornheideMuensterGermany
- Department for Plastic and Reconstructive SurgeryInstitute for Musculoskeletal MedicineWestfaelische Wilhelms‐University MuensterMuensterGermany
| | - Filipa Oliveira
- Division for Plastic SurgeryDepartment of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MuensterMuensterGermany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand SurgeryFachklinik HornheideMuensterGermany
- Department for Plastic and Reconstructive SurgeryInstitute for Musculoskeletal MedicineWestfaelische Wilhelms‐University MuensterMuensterGermany
| | - Charalampos Varnava
- Division for Plastic SurgeryDepartment of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MuensterMuensterGermany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand SurgeryFachklinik HornheideMuensterGermany
- Department for Plastic and Reconstructive SurgeryInstitute for Musculoskeletal MedicineWestfaelische Wilhelms‐University MuensterMuensterGermany
| | - Fabian Nehls
- Division for Plastic SurgeryDepartment of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MuensterMuensterGermany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand SurgeryFachklinik HornheideMuensterGermany
- Department for Plastic and Reconstructive SurgeryInstitute for Musculoskeletal MedicineWestfaelische Wilhelms‐University MuensterMuensterGermany
| | - Philipp Wiebringhaus
- Division for Plastic SurgeryDepartment of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MuensterMuensterGermany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand SurgeryFachklinik HornheideMuensterGermany
- Department for Plastic and Reconstructive SurgeryInstitute for Musculoskeletal MedicineWestfaelische Wilhelms‐University MuensterMuensterGermany
| | - Maximilian Kueckelhaus
- Division for Plastic SurgeryDepartment of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MuensterMuensterGermany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand SurgeryFachklinik HornheideMuensterGermany
- Department for Plastic and Reconstructive SurgeryInstitute for Musculoskeletal MedicineWestfaelische Wilhelms‐University MuensterMuensterGermany
| | - Tobias Hirsch
- Division for Plastic SurgeryDepartment of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MuensterMuensterGermany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand SurgeryFachklinik HornheideMuensterGermany
- Department for Plastic and Reconstructive SurgeryInstitute for Musculoskeletal MedicineWestfaelische Wilhelms‐University MuensterMuensterGermany
| | - Alexander Frederik Dermietzel
- Division for Plastic SurgeryDepartment of Trauma, Hand and Reconstructive SurgeryUniversity Hospital MuensterMuensterGermany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand SurgeryFachklinik HornheideMuensterGermany
- Department for Plastic and Reconstructive SurgeryInstitute for Musculoskeletal MedicineWestfaelische Wilhelms‐University MuensterMuensterGermany
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Glenney AE, Mocharnuk JW, Humar P, Zhang C, Rubin JP, Gusenoff JA. Analyzing the Impact of Social and Psychiatric Factors in Patients Who Undergo Body Contouring Procedures. Aesthet Surg J 2023; 44:NP119-NP124. [PMID: 37706281 DOI: 10.1093/asj/sjad297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/20/2023] [Accepted: 09/08/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND As the prevalence of obesity increases, the number of patients seeking body contouring procedures after bariatric surgery for massive weight loss is increasing. Although the positive impact of bariatric surgery on physical and emotional health is well-described, few studies have reported on the psychosocial well-being of patients undergoing body contouring procedures. Psychosocial well-being can impact patient satisfaction and maintenance of weight loss, and is an important area to study. OBJECTIVE The aim of this study was to characterize social and psychiatric factors of patients undergoing body contouring surgery, and to evaluate their impact on maintenance of weight loss. METHODS A retrospective review was performed of patients who presented to a single institution for body contouring procedures between 2002 and 2018. Demographic details, medical history, psychosocial support, and operative details were collected. Univariate analysis and multinomial logistic regressions were performed with R statistical software (version 1.3.1093). RESULTS A total of 1187 patients underwent at least 1 body contouring procedure during the study time frame. Mean BMI at presentation was 31.21 ± 10.49 kg/m2. Patients diagnosed with obesity at age 18 or older had significantly greater odds of suffering from generalized anxiety disorder (odds ratio [OR] 1.08 [95% CI, 1.02-1.15], P = .008). Patients with spousal support had 1.93 times higher odds of having maintained postbariatric weight loss at their 6-month follow-up (OR 1.93 [95% CI, 1.84-2.01], P = .028). CONCLUSIONS Social support and age of obesity diagnosis impact psychological well-being and maintenance of weight loss following body contouring procedures. LEVEL OF EVIDENCE: 3
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Toto V, Scarabosio A, Alessandri-Bonetti M, Albanese R, Persichetti P. Combined Surgery (Mommy-Makeover) Compared to Single Procedure (Abdominoplasty) in After-Pregnancy Women: A Prospective Study on Risks and Benefits. Aesthetic Plast Surg 2023; 47:2533-2542. [PMID: 37612475 DOI: 10.1007/s00266-023-03579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/19/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Mommy-makeover is becoming very popular to help them reshaping their own bodies and restoring self-perception, hardly stressed by childbearing-related changes. However, debate exists in the literature concerning safety and aesthetic outcome in patients undergoing combined procedures. The study aims to shed a light on advantages and disadvantages in mommy-makeover technique compared to conventional abdominoplasty with a particular attention to psychological aspects. MATERIALS AND METHODS In total, 37 women were enrolled at Campus Bio-Medico Hospital in Rome between October 2019 and January 2022. All of the patients were eligible for both abdominoplasty only and mommy-makeover. We proposed to the patients both procedures explaining risks and benefits; then, based on the preference of the single patient, we performed either mommy-makeover (Group A) or abdominoplasty alone (Group B). In order to evaluate patients' satisfaction and safety, multiple questionnaires were administered 9-month postoperatively (BUT, POSAS, visual perception, etc.). RESULTS The sample analyzed was composed of 37 patients (treatment group = 18, control group = 19). In the pre-post comparisons of BUT-A performed, there were statistically significant differences recorded in both groups and for all observed variables. The significance values were all less than 1% (p < 0.01). CONCLUSIONS Combined surgery proved not to be inferior in terms of patient safety. At the same time, the effectiveness in improving diastasis-related symptoms is fully comparable with single surgery. Treatment group showcases a considerable superiority in terms of body-image perception improvement and overall patient satisfaction. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Vito Toto
- Policlinico Universitario Campus Bio-Medico, Rome, Italy
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Jones HE, Faulkner HR, Losken A. The Psychological Impact of Aesthetic Surgery: A Mini-Review. Aesthet Surg J Open Forum 2022; 4:ojac077. [PMID: 36447649 PMCID: PMC9687813 DOI: 10.1093/asjof/ojac077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The purpose of this summary is to outline the available research on the psychological factors associated with aesthetic surgery. Aesthetic procedures such as abdominoplasty, breast augmentation, face lift, and rhinoplasty are shown to have unique preoperative and postoperative psychological factors. Depression and anxiety may occur after aesthetic procedures with an increased incidence in patients with certain depression prone personality traits. The pre-existing psychology of patients is also an important contributing factor to consider when evaluating surgical candidates. Pre-existing mood disorders such as depression and anxiety are shown with higher incidence in individuals pursuing aesthetic procedures and can predispose such individuals to worsening mood symptoms postoperatively. This article aims to equip surgeons with a better understanding of the common psychological factors seen in the field of aesthetic surgery, so patients can be better supported throughout all parts of the surgical process. Level of Evidence Therapeutic 5
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Affiliation(s)
- Hannah Elizabeth Jones
- Medical student, Emory University School of Medicine, Atlanta, GA, USA,Surgeons, Division of Plastic and Reconstructive Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Albert Losken
- Corresponding Author: Dr Albert Losken, 550 Peachtree Street NE, Suite 9000, Atlanta, GA 30308, USA. E-mail:
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Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring. J Clin Med 2022; 11:jcm11154315. [PMID: 35893406 PMCID: PMC9330885 DOI: 10.3390/jcm11154315] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/13/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
Due to the increased prevalence of obesity in the last decades, bariatric surgery has been on the rise in recent years. Bariatric surgery is a compelling option for weight loss in obese patients with severe obesity-related comorbidities or for whom lifestyle modifications have proven ineffective. Redundant skin following significant weight loss is a common occurrence affecting up to 96% of patients who undergo bariatric surgery, negatively impacting physical and psychosocial health and detracting from activities of daily living. Statistics of the American Society of Plastic Surgeons show that 46,577 body contouring procedures were performed after massive weight loss in the USA in a 2020 report. Abdominoplasty, a well-established cosmetic surgery procedure for improving body contour, is performed by removing excess skin and fat from the abdominal wall and thereby restoring musculofascial integrity and skin elasticity, resulting in a more ideal body shape and increasing quality of life. Although abdominoplasty is a safe procedure, it has been associated with a higher complication rate compared with other body-contouring procedures. Technologic advances over the past decade have been developed as non-invasive alternatives or adjunctive tools to surgery to enhance cosmetic results and minimize complications. New energy-based technologies may supplant invasive surgery for mild to moderate skin laxity and/or diminish the extent of surgery and resulting scars. Plastic surgeons play a significant role in improving the quality of life of patients who suffer from obesity and underwent bariatric surgery. We are deeply convinced, however, that the advancement of knowledge and research in this field will determine the introduction of new technologies and custom-made techniques. This advancement will reduce the complication rate with a rapid reintegration of the patient into the world of work and resumption of daily activities.
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