Sherin Hassan Mohammed Mehani PT, PhD , Zeinab Mohammed Helmy PT, PhD , Heba Mohammed Ali PT, PhD , Mahmoud Ibrahim Mohamed Mahmoud PT, PhD
{"title":"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。","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":"{\"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}","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}
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
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.
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.