Critical review of the justification of limitations in physical therapy and activities of daily living in cardiac surgery patients

Vitomskyi, V. V.

doi:10.5114/pq.2021.108676

Cited by 4 publications

(9 citation statements)

References 61 publications

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“…Additionally, coughing has been shown to result in sternal forces substantially greater than upper extremity movements. 1,9,11,[13][14][15] The in-depth chart review revealed that a majority of patients with aseptic osseous dehiscence (5 of the 8) experienced postoperative respiratory complications as compared with only 2 of the 8 matched comparators (see Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…The results of the present study provide an additional data point to the existing but limited body of evidence questioning the efficacy or importance of the role of traditional sternal precautions in preventing aseptic osseous sternal complications. 1,7,8,13,14…”

Section: Discussionmentioning

confidence: 99%

“…Not only are the clinical benefits of sternal precautions post-median sternotomy unclear, 1,7,8,14 the range of recommendations for which specific precautions or restrictions are necessary has been both extensive and conflicting. 8,14 Traditional sternal precautions 7,8 may be overly conservative, as research has found that coughing places greater force on the sternum than upper extremity movements and activities of daily living. 1,[13][14][15] Although prior studies have examined the potential biomechanical contributions to sternal incision complications and the outcomes of a liberalized approach to sternal precautions, no prior study has examined the possible contributions of compliance to sternal precautions and functional status to sternal incision complications.…”

mentioning

confidence: 99%

“…8,14 Traditional sternal precautions 7,8 may be overly conservative, as research has found that coughing places greater force on the sternum than upper extremity movements and activities of daily living. 1,[13][14][15] Although prior studies have examined the potential biomechanical contributions to sternal incision complications and the outcomes of a liberalized approach to sternal precautions, no prior study has examined the possible contributions of compliance to sternal precautions and functional status to sternal incision complications. Therefore, this retrospective chart review seeks to examine the relationship between functional status, compliance with sternal precautions, and postoperative aseptic osseous incision complications.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Lower Functional Status and Sternal Precaution Noncompliance May Not Be Related to Dehiscence Post-Median Sternotomy

Shoemaker,

Van Dam,

Erickson

et al. 2024

Journal of Acute Care Physical Therapy

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Introduction: The purpose of this study was to examine the relationship between functional status, compliance with sternal precautions, and aseptic osseous postoperative incision complications. Review of Literature: Although there is limited research on upper extremity use and noncompliance with sternal precautions and sternal motion, there is a paucity of literature on functional status and noncompliance with sternal precautions and their effect on actual sternal complications, specifically aseptic osseous dehiscence. Methods: A retrospective medical record review was performed on 113 patients with an incisional complication following median sternotomy. Functional status was assessed using the AM-PAC “6-Clicks” Basic Mobility Short Form and initial gait distance. Compliance to sternal precautions was assessed using clinical documentation to determine the percentage of therapy sessions requiring cues. Propensity score matching was performed to select matched comparator records for those with aseptic osseous dehiscence. A descriptive, in-depth chart review was then performed to determine other possible clinical factors contributing to complication. Results: Eight of 113 patients had aseptic osseous dehiscence. Initial AM-PAC “6-Clicks” score (U = 4.375, P = .036), initial gait distance (U = 7.252, P = .007), and number of ventilator days (U = 2.790, P = .005) were significantly different in the aseptic osseous group compared to other complication types. However, the number of ventilator days was the only variable that remained significant (U = 52.5, P = .028) between those with aseptic osseous dehiscence and the 8 matched comparators. The in-depth chart review revealed that the aseptic osseous group had respiratory complications in 5 of 8 records as compared with 2 of 8 records in the comparator group. Discussion and Conclusion: The findings of this study suggest that confounding clinical factors besides functional status and compliance to sternal precautions could have contributed to aseptic osseous dehiscence following median sternotomy. Respiratory complications postoperatively may be a key confounding factor in aseptic osseous dehiscence. Therefore, the effect of functional status and noncompliance to traditional sternal precautions remains unclear.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Lower Functional Status and Sternal Precaution Noncompliance May Not Be Related to Dehiscence Post-Median Sternotomy

Shoemaker,

Van Dam,

Erickson

et al. 2024

Journal of Acute Care Physical Therapy

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Short-Term Outcomes of Home-Based and Outpatient Programs of Physical Therapy in Patients With Frozen Shoulder and Myofascial Pain Syndrome

Rusanov,

Vitomskyi,

Roi

et al. 2024

Clin. and prev. med.

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The aim: is to compare short-term results of home-based and outpatient programs of physical therapy among patients with frozen shoulder and concomitant thoracic myofascial pain syndrome. Materials and methods. The study involved 80 patients. The range of motion in the shoulder joint affected by capsulitis was assessed. A numerical pain scale was used to assess pain sensations when pressing on trigger points. Functional limitations in the shoulder were measured by means of the Oxford Shoulder Score (before and 1.5 months after the end of the physical therapy). Participants were divided into two groups: home-based group (HG) and outpatient group (ОG). All the patients were consulted by a physical therapist. ОG patients received end-range mobilization with the assistance of a physical therapist 5 times a week to improve shoulder joint mobility. Most of ОG participants received 15 procedures (3 weeks). Patients HG performed therapeutic exercises without any assistance at home. (twice a day, 3 weeks). In terms of trigger points therapy, the patients performed ischemic compression without any assistance. Results. Patients of both groups demonstrated positive dynamics of the studied indicators. Comparison of the short-term results of the therapy according to range of motion and pain showed better indicators in the ОG. Comparison of the initial results of the groups in Oxford Shoulder Score items did not reveal any significant differences. Total score was 18.2±6.5 points in ОG and 17.6±7.5 points in HG (p=0.715). Me (25%; 75%) values were 17.5 (12.5; 23.8) and 18 (13; 23.5) points, respectively. Comparison of the final results of the groups in Oxford Shoulder Score items revealed significant differences. Total score was 47 (47; 48) points in ОG and 33 (31; 35.75) points in HG (p<0.001). x̅±SD values were 46.5±2.6 and 32.8±4.4 points, respectively. Conclusions. Short-term results of the outpatient program in terms of pain indicators, mobility of the shoulder joint and functional limitations were better as compared to the home-based program of physical therapy in patients with frozen shoulder and concomitant thoracic myofascial pain syndrome.

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Cучасні Підходи До Корекції Серцево-Судинних Ризиків У Чоловіків З Метаболічним Синдромом

Лазарєва,

Леськів

2024

СМФТтЕ

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Резюме. У статті систематизовано інформацію про поширеність серцево-судинних захво-рювань у популяції чоловіків зрілого віку з метаболічним синдромом та узагальнено підходидо корекції ризиків засобами фізичної терапії. Мета. Здійснити аналіз фахової літератури тавивчити підходи до корекції серцево-судинних ризиків у чоловіків зрілого віку з метаболіч-ним синдромом. Методи. Аналіз вітчизняних та зарубіжних джерел літератури з досліджува-ної теми. Результати. Систематизовано інформацію про засоби корекції серцево-судиннихзахворювань у чоловіків з метаболічним синдромом, наявність якого значною мірою підви-щує ризик розвитку та ускладнень серцево-судинної системи. Встановлено поширеністьхронічних неінфекційних захворювань, зокрема цукрового діабету типу II та інсуліноре-зинстентності в українській популяції. Відмічається, що метаболічний синдром у більшостівипадків є корегованим, тобто за допомогою відповідного відновлювального лікування,зокрема на основі використання засобів фізичної терапії, можна досягти зниження або хочаб зменшення основних його проявів, що надає особливого значення проблемі науковогообґрунтування, побудови та впровадження комплексної програми фізичної терапії осіб зявним ризиком розвитку серцево-судинних захворювань у поєднанні з метаболічним син-дромом. Системний аналіз фахової літератури з проблеми дослідження дозволив встано-вити, що обов’язковою умовою організації відновлювального лікування тематичних хворих єкомплексний підхід та наступність дій, що допомагає досягти довготривалого результату.Ключові слова: серцево-судинні захворювання, фізична терапія, рухова активність, спосібжиття, метаболічний синдром, ожиріння

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Critical review of the justification of limitations in physical therapy and activities of daily living in cardiac surgery patients

Cited by 4 publications

References 61 publications

Lower Functional Status and Sternal Precaution Noncompliance May Not Be Related to Dehiscence Post-Median Sternotomy

Lower Functional Status and Sternal Precaution Noncompliance May Not Be Related to Dehiscence Post-Median Sternotomy

Short-Term Outcomes of Home-Based and Outpatient Programs of Physical Therapy in Patients With Frozen Shoulder and Myofascial Pain Syndrome

Cучасні Підходи До Корекції Серцево-Судинних Ризиків У Чоловіків З Метаболічним Синдромом

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