A scoping review of abdominal wall functional assessment in patients with hernias.

BACKGROUND: Impairments in abdominal wall function are common in patients with hernias, with negative effects on their quality of life, often requiring surgical repair. Despite advances in repair techniques, there is no consistent standard for assessing abdominal wall function throughout the peri-operative period, limiting comparability between treatments. The aim of this scoping review was to identify and appraise all the available assessments of abdominal wall function reported in the literature, with a focus on the assessment methods and tools used. OBJECTIVES: To identify and review the assessment methods and tools used to measure abdominal wall function. ELIGIBILITY CRITERIA: All studies investigating abdominal wall function through any type of assessment were included. There was no restriction on the year of publication. SOURCE OF EVIDENCE: A literature search was performed of the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases in June 2025. CHARTING METHODS: Data was extracted independently by two reviewers. Extracted data included assessment tools and functional domains. RESULTS: 18 studies were included, where the majority (88.9%) of them focused on the assessment of abdominal muscle strength. Other aspects of abdominal wall function, such as trunk mobility, core stability, and postural control, were also reported but less frequently. There was considerable heterogeneity in how and when abdominal wall function was assessed and defined. CONCLUSION: This scoping review identified substantial variation in assessments of abdominal wall function. The evaluation of abdominal muscle strength remains dominant, but there is inconsistency regarding the tools and tests used, including isokinetic or isometric dynamometers, surface electromyography (sEMG), and clinical tests such as double leg lowering and trunk raising tests, assessed at different postoperative timepoints. No comprehensive or standardized method currently exists to evaluate abdominal wall function across domains and timepoints, underscoring a critical gap in clinical and research practice. Future research needs to develop or modify existing assessment methods to reflect abdominal wall function more holistically.