Effects of Myofascial Release on Cardiac Patients After Median Sternotomy

Обзор

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.

Вмешательства

• Поведенческое myofascial 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
• Поведенческое Routine 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.

Первичные конечные точки

• Maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) [Срок оценки: 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1]

Вторичные конечные точки (7)

• 1. Forced Vital Capacity (FVC) [Срок оценки: 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1]
• Forced Expiratory Volume in 1 second (FEV1) [Срок оценки: 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1]
• FEV1/FVC ratio [Срок оценки: 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1]
• Maximal Voluntary Ventilation (MVV) [Срок оценки: 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1]
• Middle and Lower chest wall mobility [Срок оценки: 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1]
• Diaphragm and sternocleidomastoid surface electromyography (sEMG) [Срок оценки: 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1]
• Pain intensity [Срок оценки: 1. Baseline 2. Day 0-5 post-ICU transfer 3. Week 1]

Критерии участия

Критерии включения

• 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

Критерии исключения

• 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

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Простое слепое

Основная цель

Лечение

Центры проведения

Тайвань · 1 центр

• Kaohsiung Veterans General Hospital — Kaohsiung City

Идентификаторы

NCT: NCT07649330 · AF02-008/15.1

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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