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Related Experiment Video

Updated: Mar 2, 2026

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Skin deformation during shoulder movements and upper extremity activities.

Weiqing Ge1, Alison Sfara1, Brittany Hians1

  • 1Department of Physical Therapy, Youngstown State University, One University Plaza, Youngstown, OH 44555, USA.

Clinical Biomechanics (Bristol, Avon)
|May 22, 2017
PubMed
Summary

Sternal precautions after cardiac surgery may not be necessary for most activities. Bilateral shoulder extension is the only movement showing significant sternal skin strain, suggesting targeted physical therapy.

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Area of Science:

  • Biomechanical engineering
  • Orthopedics
  • Cardiovascular surgery

Background:

  • Clinicians and patients question the necessity of sternal precautions post-cardiac surgery.
  • Understanding sternal skin deformation during upper extremity activities is crucial.

Purpose of the Study:

  • Determine if sternal skin deformation is compressive or distractive during shoulder movements.
  • Assess differences in skin deformation across various shoulder positions and activities.
  • Correlate sternal skin deformation with scapular stabilizer muscle strength.

Main Methods:

  • Employed a cross-sectional, non-experimental descriptive study design.
  • Utilized a 3D electromagnetic tracking system to quantify sternal skin deformation (strain).

Main Results:

  • Sternal skin strain varied significantly with shoulder abduction (P<0.01).
  • Minimal strain observed during flexion, weight lifting, chair pushing, and extension.
  • A trend of decreased strain with increased rhomboid strength was noted but not statistically significant.

Conclusions:

  • Most shoulder movements and upper extremity activities do not require sternal restriction post-cardiac surgery.
  • Bilateral shoulder extension is the primary exception, showing significant sternal strain.
  • Preoperative physical therapy to enhance scapular muscle stability may reduce sternal mechanical loading.