The Impact of a Less Restrictive Post-Sternotomy Activity Protocol Compared to Standard Sternal Precautions in Patients Following Cardiac Surgery

The Impact of a Less Restrictive Post-Sternotomy Activity Protocol Compared to Standard Sternal Precautions in Patients Following Cardiac Surgery

Guidelines following median sternotomy typically include strict sternal precautions (SP). Recently, alternative approaches propose less functional restrictions while avoiding excessive stress to the sternum. The study aimed to determine the effect of a less restrictive (LR) approach versus a standar...

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Hauptverfasser: Holloway, Caitlyn, Pathare, Neeti, Huta, Jean, Grady, Dana, Landry, Andrea, Christie, Claire, Pierce, Patricia, Bopp, Charity
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Pathare, Neeti
Huta, Jean
Grady, Dana
Landry, Andrea
Christie, Claire
Pierce, Patricia
Bopp, Charity
description Guidelines following median sternotomy typically include strict sternal precautions (SP). Recently, alternative approaches propose less functional restrictions while avoiding excessive stress to the sternum. The study aimed to determine the effect of a less restrictive (LR) approach versus a standard sternal precautions protocol after median sternotomy. The study was a cross-sectional design (n = 364; SP: n = 172, 66.3 ± 11.2 y; LR: n = 196, 65.2 ± 11.2 y). This study ran in 2 consecutive phases and compared 2 groups post median sternotomy at a community-based hospital. The LR group received instructions on the Keep Your Move in the Tube™ approach. At 2-3 weeks post discharge, sternal instability was assessed using the Sternal Instability Scale (SIS), and patients completed a self-reported survey (perceived pain rating/frequency, sternal instability, and functional mobility). The 2 groups were compared using the Mann Whitney U test and Chi square test (P 
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Recently, alternative approaches propose less functional restrictions while avoiding excessive stress to the sternum. The study aimed to determine the effect of a less restrictive (LR) approach versus a standard sternal precautions protocol after median sternotomy. The study was a cross-sectional design (n = 364; SP: n = 172, 66.3 ± 11.2 y; LR: n = 196, 65.2 ± 11.2 y). This study ran in 2 consecutive phases and compared 2 groups post median sternotomy at a community-based hospital. The LR group received instructions on the Keep Your Move in the Tube™ approach. At 2-3 weeks post discharge, sternal instability was assessed using the Sternal Instability Scale (SIS), and patients completed a self-reported survey (perceived pain rating/frequency, sternal instability, and functional mobility). The 2 groups were compared using the Mann Whitney U test and Chi square test (P &lt; 0.05). There were no significant differences between the 2 groups for all the outcomes, SIS, pain rating, pain frequency, perceived sternal instability, difficulty with functional mobility, length of stay, and discharge disposition. In our study, the implementation of the LR approach, Keep Your Move in the Tube™, had no adverse effect on outcomes 2 to 3 weeks following median sternotomy. Although no statistically significant differences were noted for all outcomes, patients with the LR approach reported less difficulty with functional mobility. These data are useful in clinical decision making regarding alternative apporaches for mobility following sternotomy.</description><identifier>EISSN: 1538-6724</identifier><identifier>DOI: 10.1093/ptj/pzaa067</identifier><identifier>PMID: 32302408</identifier><language>eng</language><publisher>United States</publisher><ispartof>Physical therapy, 2020-04</ispartof><rights>The Author(s) 2020. 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source Oxford University Press Journals All Titles (1996-Current); Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection
title The Impact of a Less Restrictive Post-Sternotomy Activity Protocol Compared to Standard Sternal Precautions in Patients Following Cardiac Surgery
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