KEEP YOUR MOVE IN THE TUBE: BREAKING DOWN THE RESTRICTED WALLS OF MOVEMENT POST-STERNOTOMY

Abstract

A major objective of undergoing cardiac surgery is to return to best possible function. However, functional activity is limited in the majority of patients, often up to 12-weeks post-operatively, because patients are asked to use sternal precautions. An alternative, evidence-based, approach is needed. We aim to prospectively compare patient oriented and safety outcomes using traditional sternal precautions relative to a newly adopted movement strategy called Keep Your Move in the Tube (KYMITT), in post-sternotomy patients. A before/after cohort design will be used. The first 100 patients will receive sternal precautions instructions. Following a 4-week washout and staff instruction period, 100 patients will receive instructions using the KYMITT strategy. The primary outcome of interest will be return to function. Other outcomes will include: pain, discomfort, wound healing, pain medication use, antibiotic use, and health services use. Follow-up will occur over 12-weeks. One hundred patients have been entered into the traditional sternal precautions group and 100 will be entered into the KYMITT strategy group. Data collection will be complete by July, 2019. Differences between the traditional sternal precautions and KYMITT strategy groups in function over time will be undertaken using unadjusted and adjusted multivariable regression modeling. Other outcomes will be analyzed similarly. The results of this study should confirm that KYMITT is a useful clinical movement strategy for post-sternotomy patients. The clinical implications may include: better return to function for the recovering patient; less onus on the caregiver/family members to assist the patient with movement; and less musculoskeletal injuries for clinical staff.View Large Image Figure ViewerDownload Hi-res image Download (PPT)