None listed
Conditions
Brief summary
Open heart surgery involves a sternotomy, where the breast bone is cut through to open up the chest and expose the heart, resulting in significant soft tissue and bony damage of the chest wall during surgery. The current physiotherapy management of patients post open heart surgery includes a walking program in conjunction with a series of trunk and upper limb exercises, globally referred to as thoracic exercises. This study aims to compare two post operative physiotherapy regimens, one with and one without thoracic exercises, in the acute hospital setting to assess the effect of open heart surgery on a patient’s physical function as well as the available movement of the trunk and shoulders. It is hypothesised that a program including thoracic mobilisation exercises will result in a more favourable outcome. Subjects will be assessed on a range of measures before surgery, and several times after surgery, including prior to discharge, four weeks post discharge and three months post surgery.
Interventions
Both intervention groups will receive standardised pre operative and post operative respiratory and mobility physiotherapy intervention.
On the day of, or prior to discharge, subjects will be randomly allocated to one of two intervention groups.
Treatment group- discharge education, walking program, thoracic mobilisation exercises to be continued post discharge until a four week post discharge follow up assessment (thereafter cardiac rehabilitation will commence).
Education program - one 30 min
Both intervention groups will receive standardised pre operative and post operative respiratory and mobility physiotherapy intervention. On the day of, or prior to discharge, subjects will be randomly allocated to one of two intervention groups. Treatment group- discharge education, walking program, thoracic mobilisation exercises to be continued post discharge until a four week post discharge follow up assessment (thereafter cardiac rehabilitation will commence). Education program - one 30 minute session only Walking program - twice daily, progressive and individual in nature, and therefore unable to specify duration of each session Thoracic mobilisation - Three times daily, hence 21 sessions per week, 10-15 minutes each session
Sponsors
Tamica Sturgess
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Subjects who are awaiting, and subsequently undergo, inpatient or elective open heart surgery via a median sternotomy at Monash Medical Centre, Clayton campus.2. Subjects who provide informed consent to participate in the pilot project.
Exclusion criteria
1. The subject is unable to complete the preoperative surveys and outcome measure tests, including instances where: the subject is transferred to MMC with insufficient time to preoperatively be assessed, they are too medically unstable to complete the preoperative tests, or if the subject is unable to give informed, written consent.2. The subject has a premorbid cognitive impairment, preventing the completion of a thoracic mobilisation exercise regimen (eg. Severe dementia).3. The subject has a premorbid severe physical impairment - where they cannot attain bilateral shoulder flexion above 90º and thus preventing the completion of thoracic mobilisation exercises (eg. Severe shoulder OA).- severe ongoing spinal and/or shoulder problems requiring treatment, which may confound results (eg rotator cuff injury).- conditions where obtaining a true sagittal image for ROM testing is difficult (eg severe scoliosis).4. The subject is unable to read English and understand spoken English.
Outcome results
None listed