The Five Diaphragms in Patients Following Cardiac Surgery in Sternotomy: An Observational Study

Abstract

The recovery and rehabilitation process of patients following heart surgery in sternotomy is lengthy and requires significant time. This observational study on five diaphragms in patients undergoing a sternotomy is the first of its kind.Objectives: Evaluate the position of the 5 bodily diaphragms, creating a platform of useful information for the practice of manual therapy. Understand if the diaphragm position coincides with the clinical status of the patient.Setting: Department for Cardiac Rehabilitation, Foundation Don Carlo Gnocchi IRCCS. Materials and methods:From January 2012 to July 2016, 300 cardiac patients underwent evaluation following a cardiothoracic intervention. In a supine position, palpation was conducted on the pelvic floor, the respiratory diaphragm, the thoracic outlet, the buccal floor and the cerebellar tentorium. The evaluation was undertaken on the first day of recovery in the ward. Rating scales were conducted such as the VAS, the walking test and the air life, an instrument for measuring the volume of air inhaled.Results: Eleven different positional organisation structures of the 5 diaphragms have been highlighted which do not correspond to the patient's clinical status. Conclusions:The data collected from the study allows us to obtain important information to guide the work of the manual therapist, but does not have a direct relationship with the patient's functional status.