Effect of Trunk Stabilizing Exercises on Patients With Median Sternotomy After Heart Valve Surgery
Effect of Trunk Stabilizing Exercises on Patients With Median Sternotomy After Heart Valve Surgery
PURPOSE:

 The aim of this study is to investigate the effect of trunk stabilizing exercises on sternal
 instability in patients with median sternotomy after heart valve surgery
Valvular heart disease constitutes a growing healthcare problem with a general prevalence of
 2%-5% and a prevalence of 13% after the age of 75 years. Heart valve surgery can be a
 lifesaving procedure for patients with severe symptomatic heart valve disease. Nevertheless,
 following the surgery, up to 27% of patients may require readmission within 30 days after
 discharge. Following heart valve surgery, some patients report anxiety and worries related to
 readmission and reoperations, postoperative complications, and deconditioning which may
 prevent or delay return to work and limit activities of daily living Trunk stabilizing
 exercises train and activate the abdominal and anterior thoracic cage muscles to assist in
 stabilizing the bisected sternum, thereby decreasing the undue motion in both sagittal and
 transverse planes during trunk movement. Patients' complaints of pain and discomfort
 associated with sternal instability post-cardiac surgery may be managed by diminishing the
 degree of this undue motion between the edges of the divided sternum, and thus provides a
 conservative treatment for sternal instability forty female patients will be divided into two
 groups. group A received trunk stabilizing exercise and group B will receive routine cardiac
 rehabilitation; three times/week for four weeks. the outcome variables were sternal
 instability and sternal separation and measured before and after completion of treatment
Inclusion Criteria:

 1. age between 40 and 50 years, female gender

 2. hemodynamic stability

 3. BMI from 25 to 29.9 kg/m2

 4. they will have acute sternal instability.

 Exclusion Criteria:

 1. previous thoracic surgery

 2. elective and urgent coronary artery bypass surgery

 3. respiratory insufficiency after surgery manifesting hypoxemia with partial pressure of
 oxygen in arterial blood <60 mmHg

 4. renal insufficiency with serum creatinine ≥1.8 mg/dl after surgery

 5. low cardiac output syndrome with ST segment elevation in multiple electrocardiogram
 leads, cardiac arrhythmias, or hypotension, according to the American College of
 Cardiology Foundation and American Heart Association

 6. other medical conditions such as diabetes, uncontrolled hypertension and obesity

 7. Past medical history that include conditions that may have influenced the provision of
 physiotherapy interventions such as (severe asthma, chronic airflow limitation,
 bronchiectasis, ankylosing spondylitis or lumbar disc prolapse