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低水平激光疗法与躯干稳定练习对冠状动脉旁路移植术后胸骨切开愈合的影响:一项随机临床试验。

Low-level laser therapy versus trunk stabilization exercises on sternotomy healing after coronary artery bypass grafting: a randomized clinical trial.

机构信息

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.

出版信息

Lasers Med Sci. 2019 Aug;34(6):1115-1124. doi: 10.1007/s10103-018-02701-4. Epub 2018 Dec 13.

Abstract

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.

摘要

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。

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