Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Beni-Suef University, Benisuef Elgadata, Street No. 18, Beni-Suef governorate, 62511, Egypt.
Lasers Med Sci. 2019 Aug;34(6):1115-1124. doi: 10.1007/s10103-018-02701-4. Epub 2018 Dec 13.
The aim of this study was to investigate the effects of low-level laser therapy (LLLT) versus trunk stabilization exercises on sternotomy healing following coronary artery bypass grafting (CABG) surgery. Forty-five male patients who had acute sternal instability post-CABG surgery in the age range of 45-65 years were divided randomly into three equal groups (n = 15). The laser group received LLLT, while the exercise group received trunk stabilization exercises. The control group only received a routine cardiac rehabilitation programme, which was also provided to both the laser and the exercise groups. All groups were offered 12 sessions over 4 weeks. Sternal separation, median sternotomy photographic analysis, pain and activities of daily living (ADL) performance were evaluated pre- and post-treatment. Statistical significance was set at P < 0.05. There was a significant decrease among the laser group in upper-sternal separation, while the exercise and control groups showed a non-significant decrease. In terms of mid-sternal separation, laser and exercise groups showed a significant decrease while the control group showed a non-significant decrease. In terms of lower-sternal separation, the exercise group showed a significant decrease, while the laser and control groups showed a non-significant decrease. Post-treatment between-groups analysis showed a significant difference only among the laser and control groups with regard to upper-sternal separation, while analysis of the laser, exercise and control groups in the case of upper-sternal separation and the between-groups comparison in terms of mid- and lower-sternal separation revealed no significant differences. LLLT and trunk stabilization exercises were found to be the most effective methods for sternotomy healing post-CABG surgery, with LLLT offering superior performance in the case of the upper sternum while trunk stabilization exercises were more effective for the lower sternum.
本研究旨在探讨低水平激光疗法(LLLT)与躯干稳定运动对冠状动脉旁路移植术(CABG)后胸骨切开愈合的影响。45 名年龄在 45-65 岁之间的 CABG 术后急性胸骨不稳定的男性患者被随机分为三组(每组 15 名)。激光组接受 LLLT,运动组接受躯干稳定运动。对照组仅接受常规心脏康复计划,该计划也提供给激光组和运动组。所有组均接受 4 周内 12 次治疗。治疗前后评估胸骨分离、胸骨正中切开摄影分析、疼痛和日常生活活动(ADL)表现。统计显著性设为 P<0.05。激光组胸骨上段分离显著减少,而运动组和对照组无显著减少。在胸骨中段分离方面,激光组和运动组显著减少,而对照组无显著减少。在胸骨下段分离方面,运动组显著减少,而激光组和对照组无显著减少。组间治疗后分析显示,仅激光组和对照组在胸骨上段分离方面有显著差异,而在胸骨上段和中段分离方面对激光组、运动组和对照组的分析以及胸骨下段分离的组间比较均无显著差异。LLLT 和躯干稳定运动被发现是 CABG 术后胸骨切开愈合的最有效方法,LLLT 在胸骨上段表现更优,而躯干稳定运动对胸骨下段更有效。