Trunk stabilisation exercises reduce sternal separation in chronic sternal instability after cardiac surgery: a
Doa El-Ansary1, Gordon Waddington, Roger Adams
1The university of Sydney, Australia. Doa.El-Ansary@canberra.edu.au
Question:
Do trunk stabilisation exercises reduce sternal separation and pain, and improve the quality and control of the performance of tasks in individuals with chronic sternal instability?
Design:
Randomised crossover study with concealed allocation and intention-to-treat analysis.
Participants:
Nine individuals with chronic sternal instability following a median sternotomy for cardiac surgery.
Intervention:
The experimental intervention consisted of six weeks of trunk stabilisation exercises; the control intervention was no exercises.
Outcome Measures:
Outcomes were sternal separation measured by ultrasound in mm, pain during the performance of nine everyday tasks measured on a 100-mm visual analogue scale, and the quality and control of the performance of two tasks scored on a 100-mm visual analogue scale.
Results:
Overall, sternal separation during the period of trunk stabilisation exercises decreased by 6.2 mm (95% CI 3.5 to 8.9) more than during the control period. Overall, pain decreased when performing everyday tasks by 14 mm (95% CI 5 to 23) more than during the control period. Overall, task performance during the period of trunk stabilisation exercises did not improve (mean difference 10 mm, 95% CI -3 to 22) more than during the control period.
Conclusion:
Trunk stabilisation exercises should be included in the rehabilitation of individuals who experience sternal instability following cardiac surgery. A larger trial is warranted to determine if stabilisation exercises are beneficial in improving the quality and control of task performance.
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