Aortic Aneurysm and Dissection, Coronary Artery Disease (CAD), Valve Heart Disease
Conditions
Keywords
Median Sternotomy, Cardiac Surgery, Coronary Artery Disease, Aortic Aneurysm, Aortic Dissection, Valvular Heart Disease
Brief summary
After deciding to join this study and signing the informed consent form, participants will undergo the following interventions: All participants will receive a preoperative assessment (Tp) before surgery. Within five days after transferring from the ICU to the general ward, participants will receive a baseline assessment (T0). After completing seven sessions of myofascial release (MFR), a post-intervention assessment (T1) will be conducted. Assessments include maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), pulmonary function tests, mid- and lower-thoracic mobility, surface electromyography (sEMG) to measure diaphragmatic and sternocleidomastoid muscle activity, and pain scores. Pulmonary function tests include forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, and maximum voluntary ventilation (MVV). Participants will be randomly assigned to an intervention group or a control group. The intervention group will receive myofascial release therapy in addition to routine physical therapy in the general ward. Routine therapy includes daily physical therapy sessions such as out-of-bed activities, incentive spirometry training (Triflow), and functional exercises. The MFR intervention consists of three steps: The therapist places both hands on the thoracic outlet, with the index and middle fingers above the clavicle. One hand is placed on the anterior chest and the other hand parallel on the participant's back. Both hands are placed on the anterolateral region of the thoracoabdominal diaphragm. During each step, participants are instructed to take 10 slow, deep breaths and direct airflow toward the therapist's hands. Each session lasts approximately 15 minutes, once daily, for seven sessions. The control group will receive only routine physical therapy (out-of-bed activities, incentive spirometry, and functional exercises) without additional myofascial release therapy.
Interventions
BEHAVIORALmyofascial release+Routine Physical Therapy
Participants in the intervention group will receive seven daily sessions of myofascial release (MFR), approximately 15 minutes each, in addition to routine physical therapy. Routine therapy includes out-of-bed activities, incentive spirometry training (Triflow), and functional exercises. The MFR procedure consists of three steps: Therapist places both hands on the thoracic outlet, with index and middle fingers above the clavicle. One hand is placed on the anterior chest and the other parallel on the participant's back. Both hands are placed on the anterolateral thoracoabdominal region. During each step, participants are instructed to take 10 slow, deep breaths, directing airflow toward the therapist's hands.
BEHAVIORALRoutine Physical therapy
Participants in the control group will receive routine physical therapy only, including out-of-bed activities, incentive spirometry training (Triflow), and functional exercises. No additional myofascial release therapy will be provided.
Sponsors
Siou-Pin Huang
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Able to communicate verbally and follow instructions * Diagnosed by a physician with coronary artery disease, valvular disease, or aortic disease * Undergoing median sternotomy * Able to provide informed consent
Exclusion criteria
* Presence of a cardiac pacemaker * Presence of a ventricular assist device (VAD) * Existing central nervous system disorders (e.g., hemorrhagic or ischemic stroke, spinal cord injury, traumatic brain injury) * Cognitive impairment or inability to understand/follow instructions * Diagnosed with chronic obstructive pulmonary disease (COPD) * History of previous thoracic surgery * ICU stay longer than 14 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) | 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1 | 1. Maximum Inspiratory Pressure (MIP): Unit : cmH₂O 2. Maximum Expiratory Pressure (MEP): Unit : cmH₂O |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 1. Forced Vital Capacity (FVC) | 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1 | 1\. Forced Vital Capacity (FVC) Unit of Measure: liters (L) |
| Forced Expiratory Volume in 1 second (FEV1) | 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1 | Forced Expiratory Volume in 1 Second (FEV1) Unit of Measure: liters (L) |
| FEV1/FVC ratio | 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1 | FEV1/FVC Ratio Unit of Measure: percentage (%) |
| Maximal Voluntary Ventilation (MVV) | 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1 | Maximal Voluntary Ventilation (MVV) Unit of Measure: liters/minute (L/min) |
| Middle and Lower chest wall mobility | 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1 | Chest Wall Mobility Unit of Measure: centimeters (cm) |
| Diaphragm and sternocleidomastoid surface electromyography (sEMG) | 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1 | Diaphragm Surface Electromyography Activity Sternocleidomastoid Surface Electromyography Activity Unit of Measure: microvolts (µV) |
| Pain intensity | 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1 | Pain intensity measured using the Numeric Rating Scale (NRS). (0-10) |
Countries
Taiwan
Contacts
CONTACTSiou Pin Huang, PT (Physical Therapist)
Outcome results
None listed