Research (R1–R44)
R01 Sternal Micromotion During Early Weighted Upper Limb Exercise Following Median Sternotomy: An Interim Analysis of the SAFE-ARMS Study

https://doi.org/10.1016/j.hlc.2021.03.159Get rights and content

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Background

Sternal precautions that limit the use of the upper limb and trunk remain routine after cardiac surgery via median sternotomy, despite evidence to support active upper limb movements. This study address a gap by investigating sternal micromotion during upper limb resistance exercises in the early post-operative period.

Methods

Eight males following median sternotomy (72.9±6.9 years) have participated in the resistance arm of a pilot randomised controlled trial to date. Six upper limb exercises (seated row, shoulder pulldown, shoulder press, bicep curl, triceps dip and lateral raise) were assessed at 2, 8 and 14 weeks postoperatively. Sternal edge motion in the lateral (coronal plane) and anterior-posterior (sagittal plane) directions was measured using real-time ultrasound at the mid and lower sternum, at 6cm and

Results

Maximum sternal micromotion occurred in the coronal plane during the biceps curl 0.7±1.0mm (-0.5-1.9), triceps dip 1.0±0.8mm (-0.4-1.7), shoulder press 0.8± 0.8mm (-0.2-1.8), lateral raise 0.8±0.7mm (-0.4-1.7) and seated row 0.8±0.7mm (-0.2-1.8). Maximum sternal micromotion occurred in the sagittal plane for the shoulder pulldown -0.9±0.4mm (-0.2-1.6), indicative of a reduction in sternal separation from rest. Pain at rest was 0/10 at 2 weeks, 0/10 at 8 weeks and 0/10 at 14 weeks. No increase

Conclusions

Interim analysis of early upper limb resistance exercise demonstrates safety and feasibility with respect to sternal micromotion and pain.

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