Functional Outcomes of Patients With Sternectomy After Cardiothoracic Surgery: A Case Series.
Functional outcomes of patients with sternectomy after cardiothoracic surgery: a case series.
Filed under: Rehab Centers
Cardiopulm Phys Ther J. 2012 Dec; 23(4): 5-11
Irons SL, Hoffman JE, Elliott S, Linnaus M
One potential complication after cardiothoracic surgery involves mediastinitis, which may lead to a sternectomy. A sternectomy involves partial or total debridement of the sternum to remove infected bone. Little evidence regarding functional outcomes following sternectomy exists in literature. The purpose of this case series is to report the demographics of 6 patients admitted to a long term acute care hospital (LTACH) treated for sternectomy after open heart surgery, along with presenting length of stay (LOS) data, analyzing functional outcomes, and describing the physical therapy (PT) interventions used with these patients to obtain the reported functional outcomes.Medical charts were reviewed retrospectively. Information in four main areas were extrapolated from the chart and further analyzed: patient demographics, length of hospital stay (acute care and LTACH), admission and discharge FIM scores, and information about the PT interventions (both numerical and descriptive).Patients included 5 males and 1 female with an age range of 65-78 years old (mean 70 years old, SD 4.8 years). Patients had a total mean acute care LOS of 26.33 (12.26) days and total mean LTACH LOS of 27.67 (11.74) days. Median total FIM score at admission was 80.00 [range 58.00-94.00], while the median total FIM score at discharge increased significantly to 106.50 [range 86.00-116.00] (p = 0.031). Total mean FIM score change during LTACH stay (efficiency) was 25.17 (3.25), and FIM score change per day (efficacy) was 1.23 (0.46). Median motor score had a significant increase from admission to discharge (p = 0.031). Median cognitive score did not significantly change from admission to discharge (p = 0.125). PT interventions used with this patient population were presented and described, with a mean number of PT sessions in LTACH of 27.33 (15.38) (range = 10-46).Although patients required an increased acute care LOS and an additional stay on LTACH, all 6 patients were discharged home following a course of multi-disciplinary inpatient rehabilitation on a LTACH unit. Patients are able to make significant functional gains during rehabilitation following sternectomy, as evidenced by increases in FIM score.
HubMed – rehab
Sexual concerns and practices after ICD implantation: findings of the COPE-ICD rehabilitation trial.
Filed under: Rehab Centers
Eur J Cardiovasc Nurs. 2013 Jan 8;
Berg SK, Elleman-Jensen L, Zwisler AD, Winkel P, Svendsen JH, Pedersen PU, Moons P
Background:Studies show that patients with implantable cardioverter defibrillators (ICD) frequently experience sexual dysfunction. These experiences are often linked to exercise intolerance, side-effects of medication, and psychological problems.Objective:To describe (a) the level of information given about sexual activity, (b) the areas of patient concerns related to sexual function and the ICD, and (c) changes in sexual behavior.Methods:A randomized controlled trial including 196 patients (1:1) was designed, including 12 weeks of exercise training and 1 year of psycho-educational follow-up focusing on modifiable factors associated with poor outcomes, including sexual functioning. The Sex After ICD Survey was administered 6 months after the randomization as part of the planned explorative outcomes. 141 patients responded.Results:The analyses showed that 37 of the 69 (55.2%) patients of the intervention group and 16 of the 72 (24.6%) patients of the control group received information (p<0.001). The areas of greatest concern reported by many patients were: lack of interest in sex, erectile dysfunction, and an over-protective partner. Fewer patients were sexually active 6 months after the ICD implantation than before the ICD implant: 51.8% versus 66.7%. In the intervention group, patients had sexual intercourse a mean of 4.9 times during the previous 2 months versus 4.0 in the control group (p=0.4).Conclusion:Despite having received more information, no interventional effect was found between groups in terms of sexual concerns or activity. HubMed – rehab
Republished research: Effects of circuit training as alternative to usual physiotherapy after stroke: randomised controlled trial.
Filed under: Rehab Centers
Br J Sports Med. 2013 Feb; 47(3): 178
van de Port IG, Wevers LE, Lindeman E, Kwakkel G
When ‘strong’ might be wrong: Evaluating the evidence in CRPS management.
Filed under: Rehab Centers
Eur J Pain. 2013 Feb; 17(2): 143-4
O’Connell NE, Wand BM
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