Physiotherapy Exercises in Patients With Sternal Instability After Cardiovascular Surgery

Not Applicable

Completed

• Conditions: Mediastinitis; Cardiovascular Infections; Coronary Artery Disease
• Interventions: Other: physiotherapy exercises

• Registration Number: NCT02513576
• Lead Sponsor: Emilia Nozawa, PT PhD

Brief Summary

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

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.

Study Timeline

• Study Start: 2011-10
• Primary Completion: 2012-01
• Study Completion: 2015-03
• Study First Submitted: 2015-06-30
• Study First Submitted QC: 2015-07-30
• Study First Posted: 2015-07-31
• Status Verified: 2015-08
• Last Update Submitted: 2015-08-03
• Last Update Posted: 2015-08-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 30

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Physiotherapy exercises	physiotherapy exercises	Two strategies of abdominal exercises with and without movement of the upper limbs applied in patients with sternal instability as randomization.

Primary Outcome Measures

Name	Time	Method
Improvement of pulmonary function	3 weeks	Measure of maximal muscles respiratory pressures and spirometry tests

Secondary Outcome Measures

Name	Time	Method
Measure of pain on the Visual Analog Scale	3 weeks	Pain Visual Analog Scale
Discomfort - using Discomfort Scale	3 weeks	Activities using Discomfort Scale