Physiotherapy Exercises in Patients With Sternal Instability After Cardiovascular Surgery

Study Overview
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Brief Summary
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Sternal instability caused by mediastinitis is one of the most feared complications for cardiac surgery team for generating large commitments and functional damages to patients. Biomechanically, the contraction of abdominal muscles such as transverse abdominal, produces forces that result in a corset-like action and anterior thoracic cage muscles too may assist in stabilizing the sternum. Thus, strengthening the abdominal muscles might contribute to the recovery of functional aspects. The aim was to evaluate whether contraction and strengthening the abdominal muscles could improve lung function and respiratory muscle strength in patients with sternal instability.

Detailed Description
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Sternal instability was confirmed by physical examination and confirmed by chest tomography. The data were collected before and after the 3-week period of intervention. Sternal instability way assessed by the unstable sternal scale, graduated from zero to 4 points. The respiratory muscle strength was measured through Manuvacuometry and the pulmonary function by the spirometry. Pain was recorded by using a Visual Analog Scale (0 -10); Discomfort Scale( 0-10) and Identification of Activities that cause pain and discomfort. Patients underwent abdominal exercise protocol for three weeks once a day, lasting about 15 minutes followed by the physiotherapist.

Official Title
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A Randomized, Controlled Study of Physiotherapy Exercises in Patients With Sternal Instability Due to Mediastinitis After Cardiovascular Surgery

Conditions
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Mediastinitis, Coronary Artery Disease, Cardiovascular Infections

Intervention / Treatment
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* Other: physiotherapy exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Postoperative period of cardiovascular surgery by median sternotomy with sternal instability Written Inform consent Exclusion Criteria: Chest Tube Hemodynamic instability Neurological alteration Active infection

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Physiotherapy exercises<br>Two strategies of abdominal exercises with and without movement of the upper limbs applied in patients with sternal instability as randomization. | Other: physiotherapy exercises<br>* Consisted of trunk stabilization exercises.The exercises were undertaken for 15 minutes every day for tree weeks. Patients were the contract their abdominal muscles with an emphasis on the transverse abdominal. Patients were to contract their abdominal muscles in a supine,sitting and stand up position.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvement of pulmonary function | Measure of maximal muscles respiratory pressures and spirometry tests | 3 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measure of pain on the Visual Analog Scale | Pain Visual Analog Scale | 3 weeks | 
| Discomfort - using Discomfort Scale | Activities using Discomfort Scale | 3 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sternal instability, physical therapy, Respiratory muscle strength