The impact of a less restrictive post-sternotomy activity protocol compared with standard sternal precautions in patients following cardiac surgery: A systematic review

Abstract

Despite limited evidence, to support movement and weight limitations following median sternotomy, sternal restrictions are routinely prescribed. This systematic review aims to determine what the literature defines as sternal restrictions, how sternal restrictions are applied and progressed; what are the less restraining sternal restrictions, revised sternal restrictions, and uniformity in the prescription of sternal restrictions. (N=2027) studies were identified. Databases screened were CINAHL (1957), PubMed (47), EMBASE (06), ICTRP (04), and COCHRANE (13). After including scholarly articles, screening records, removing duplicates, and including potentially relevant articles, Five (n = 5) studies were included in the qualitative synthesis. Studies included papers written in English. A precautionary approach, rather than a restraining attitude would expedite better healing and practicable recovery post-median sternotomy. This comprehensive analysis clearly supports the fact that patients need progressive rehabilitation after surgery to enhance thoracic motion, pulmonary function, symptoms, and functional status.

Keywords

• exercises
• heart surgery
• post-surgery care
• post-surgical-issues
• sternal approach
• sternal instability/dehiscence
• sternal wound infection
• surgery/thorax/heart