Implementing Evidence to Inform Recovery After Cardiac Surgery via Median Sternotomy Is Feasible and Effective Using...

Area of Science:

• Cardiovascular Surgery
• Rehabilitation Medicine
• Knowledge Translation

Background:

• Patients undergoing cardiac surgery with median sternotomy often face activity restrictions to prevent sternal complications.
• The
• Keep Your Move in the Tube
• (KMIT) strategy aims to facilitate early functional recovery using biomechanical principles.
• Inconsistent KMIT implementation hinders optimal patient outcomes.

Purpose of the Study:

• To review current practices for post-sternotomy exercise in Australian cardiac rehabilitation programs.
• To assess the implementation of the KMIT strategy using the Knowledge to Action framework.

Main Methods:

• A prospective, longitudinal, observational study employing the RE-AIM framework.
• Phases included a survey of cardiac rehabilitation practices, co-design of an implementation strategy, intervention delivery, and assessment.

Main Results:

• Survey revealed inconsistent post-sternotomy lifting and weight-bearing advice across programs.
• Clinician education increased KMIT familiarity (11% to 76%) and integration into practice (23% to 82%).
• Despite high adoption, uncertainty persists regarding specific load and time restrictions post-sternotomy.

Conclusions:

• A structured co-design and implementation process successfully embedded KMIT in cardiac rehabilitation programs.
• The study identified needs for future strategies to enhance consistency, translation, and sustainability of KMIT.
• Further refinement is needed to address lingering uncertainties about post-sternotomy restrictions.