Discrepancy regarding optimal sternal precautions (SP) exists with many rehabilitation professionals (RP) uncertain about best practice to ensure patient safety and proper progression after a median sternotomy (MS). The purpose of this study was to survey US cardiothoracic surgeons (CTS) about the SP that they provide to patients with a goal of developing universal SP to optimize patient function and decrease secondary impairments after a MS.
A survey instrument consisting of 20 questions underwent extensive development and testing (2 pilot runs) prior to the administration of the survey to 1,000 CTS randomly taken from a convenience sample of 3,000 CTS who were members of the American College of Surgeons. The survey was mailed with return postage rather than being electronically administered in hopes of a greater response rate. A reminder postcard was sent 2 weeks after the initial mailing.
Despite the response rate being surprisingly low (10%), the survey results were very consistent among the respondents. The greatest percentage of respondents was from the Northeast and Southeast regions of the US (33%). The mean respondent age and years of surgical experience were 42 ± 25 and 20 ± 18 years, respectively. The mean number of MS performed per week was 6 ± 14 with the most common reason for MS being bypass graft surgery (60%). The top five SP in descending order were (1) lifting no more than 10 pounds of weight bilaterally, (2) lifting no more than 10 pounds of weight unilaterally, (3) bilateral sports restrictions, (4) unilateral sports restrictions, and (5) active bilateral shoulder flexion no greater than 90 degrees. Ninety-five percent of CTS provide patients education materials on SP.
Despite a relatively poor response rate, consistent survey results identified the top five SP which provides RP with useful information to optimize patient function and decrease secondary impairments after a MS.
Optimal implementation of SP by RP should incorporate the top five SP reported by CTS after a MS.
Lawrence Cahalin, No Financial Disclosure Information; No Product/Research Disclosure Information