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Early Supervised Incremental Resistance Training Versus Standard Care Following Median Sternotomy-A Preliminary
Nur Ayub Mohd Ali1,2,3, Mohd Ali Katijjahbe1,2,4, Doa El-Ansary5,6,7
1Cardiovascular Research and Pulmonary Group, Universiti Kebangsaan Malaysia (UKM), 43600 Bangi, Malaysia.
Objectives:
To evaluate the safety and feasibility of implementing a supervised incremental UL resistance training program in the early postoperative period, and to investigate its initial effects on UL function and patient-reported pain at four weeks and three months after median sternotomy.
Methods:
This study is a report of the preliminary analysis of a phase II prospective, double-blind, randomized controlled trial that tested the Early Supervised Incremental Resistance Training intervention following a median sternotomy and explored its effects on upper limb function and patient-reported pain at 4 weeks and at 3 months.Primary outcomes were safety (defined by sternal wound complications); feasibility (assessed by recruitment and adherence); and upper limb function (measured by the Unsupported Upper Limb Exercise Test). Secondary outcomes included the Functional Difficulty Questionnaire Shortened Version and pain using the Numeric Rating Scale. Assessments occurred at baseline, discharge, 4 weeks and 3 months postoperatively.
Results:
Fifty-five participants were recruited (Early Supervised Incremental Resistance Training, n = 27; standard care, n = 28). No sternal complications occurred (relative risk, 0.963; 95% confidence interval, 0.057-16.21). Adherence was 80%, with no dropouts. Between-group differences in the Unsupported Upper Limb Exercise Test were not significant at 4 weeks (mean difference (MD), 1.49; 95% confidence interval, -4.62 to 7.16) or 3 months (mean difference (MD) 1.19; 95% confidence interval, -5.58 to 7.79). No significant differences were found for the Functional Difficulty Questionnaire Shortened Version or the Numeric Rating Scale. Within-group analyses showed significant improvements in the Unsupported Upper Limb Exercise Test, the Functional Difficulty Questionnaire Shortened Version and the Numeric Rating Scale over time.
Conclusions:
The Early Supervised Incremental Resistance Training was safe, feasible and well-accepted in the acute inpatient setting, with strong recruitment and adherence and no adverse events.
Trial Registration:
ISRCTN 17842822, registered 11 March 2020.
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