Effect of Adding Integrated Core and Graduated Upper Limb Exercises to Inpatient Cardiac Rehabilitation on Sternal Instability After Coronary Artery Bypass Grafting: A Randomized Controlled Trial

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2024-12-01 DOI:10.1016/j.apmr.2024.08.012

Sherin Hassan Mohammed Mehani PT, PhD , Zeinab Mohammed Helmy PT, PhD , Heba Mohammed Ali PT, PhD , Mahmoud Ibrahim Mohamed Mahmoud PT, PhD

{"title":"Effect of Adding Integrated Core and Graduated Upper Limb Exercises to Inpatient Cardiac Rehabilitation on Sternal Instability After Coronary Artery Bypass Grafting: A Randomized Controlled Trial","authors":"Sherin Hassan Mohammed Mehani PT, PhD , Zeinab Mohammed Helmy PT, PhD , Heba Mohammed Ali PT, PhD , Mahmoud Ibrahim Mohamed Mahmoud PT, PhD","doi":"10.1016/j.apmr.2024.08.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of adding integrated core and graduated resistance upper limb exercises to an inpatient cardiac rehabilitation program in patients with acute sternal instability after coronary artery bypass grafting (CABG)<strong>.</strong></div></div><div><h3>Design</h3><div>This was a single-center, randomized, controlled, parallel-group intervention study.</div></div><div><h3>Setting</h3><div>This study was conducted at the National Heart Institute.</div></div><div><h3>Participants</h3><div>Forty patients with post-CABG with sternal instability aged 50-60 years completed this study and were randomized into 2 groups: an intervention group (n=20) and an active control group (n=20).</div></div><div><h3>Intervention</h3><div>The intervention group (A) received a routine inpatient rehabilitation program from the first postoperative day plus integrated core and graduated resistance upper limb exercises, which started from the seventh postoperative day for approximately 4 weeks, whereas the control group (B) received only the routine inpatient rehabilitation program.</div></div><div><h3>Main Outcome Measures</h3><div>Sternal separation measured by ultrasonography, visual analog scale for measuring pain, and activities of daily living (ADL) index were main outcome measures.</div></div><div><h3>Results</h3><div>Patients in the intervention group (A) showed a significant reduction in sternal separation from the supine and long sitting positions, whereas those in the control group (B) showed a significant increase in sternal separation (<em>P</em>=.0001). Both groups showed a reduction in pain, and an increase in the ADL score was observed in group A. There was a significant interaction between the time and group effects (<em>P</em>=.0001).</div></div><div><h3>Conclusion</h3><div>Adding integrated core and graduated upper limb exercises to inpatient cardiac rehabilitation for patients with sternal instability after coronary artery bypass grafting significantly improved sternal healing, pain, and ADL.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2245-2252"},"PeriodicalIF":3.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0003999324011936","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To evaluate the effect of adding integrated core and graduated resistance upper limb exercises to an inpatient cardiac rehabilitation program in patients with acute sternal instability after coronary artery bypass grafting (CABG).

Design

This was a single-center, randomized, controlled, parallel-group intervention study.

Setting

This study was conducted at the National Heart Institute.

Participants

Forty patients with post-CABG with sternal instability aged 50-60 years completed this study and were randomized into 2 groups: an intervention group (n=20) and an active control group (n=20).

Intervention

The intervention group (A) received a routine inpatient rehabilitation program from the first postoperative day plus integrated core and graduated resistance upper limb exercises, which started from the seventh postoperative day for approximately 4 weeks, whereas the control group (B) received only the routine inpatient rehabilitation program.

Main Outcome Measures

Sternal separation measured by ultrasonography, visual analog scale for measuring pain, and activities of daily living (ADL) index were main outcome measures.

Results

Patients in the intervention group (A) showed a significant reduction in sternal separation from the supine and long sitting positions, whereas those in the control group (B) showed a significant increase in sternal separation (P=.0001). Both groups showed a reduction in pain, and an increase in the ADL score was observed in group A. There was a significant interaction between the time and group effects (P=.0001).

Conclusion

Adding integrated core and graduated upper limb exercises to inpatient cardiac rehabilitation for patients with sternal instability after coronary artery bypass grafting significantly improved sternal healing, pain, and ADL.

查看原文本刊更多论文

冠状动脉旁路移植术后，在住院心脏康复治疗中增加综合核心锻炼和分级上肢锻炼对胸骨不稳定性的影响；随机对照试验。

目的评估在冠状动脉旁路移植术（CABG）后急性胸骨不稳患者的住院心脏康复计划中增加综合核心和渐进阻力上肢运动的效果：这是一项单中心、随机对照、平行组干预研究：研究在美国国家心脏研究所进行：40 名 50-60 岁胸骨不稳的 CABG 术后患者完成了这项研究，并被随机分为两组：干预组（20 人）和积极对照组（20 人）：干预组（A）从术后第一天开始接受常规住院康复计划，并从术后第七天开始进行综合核心和渐进阻力上肢锻炼，持续约四周；对照组（B）仅接受常规住院康复计划：主要结果指标：超声波测量胸骨分离度、疼痛视觉模拟量表和日常生活活动（ADL）指数：结果：干预组（A）患者从仰卧位和久坐位开始胸骨分离明显减少，而对照组（B）患者胸骨分离明显增加（P = 0.0001）。两组的疼痛均有所减轻，A 组的 ADL 评分有所提高，时间与组间效应之间存在显著的交互作用（p = 0.0001）：结论：在冠状动脉旁路移植术后胸骨不稳患者的住院心脏康复治疗中加入综合核心锻炼和渐进式上肢锻炼，可显著改善胸骨愈合、疼痛和日常活动能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.