ABSTRACT
Background: Kinesiophobia has been reported as one of the most common factors that hinder the exercise based cardiac rehabilitation. According to the evidences in the literature and clinical observations, chest binder is prescribed post median sternotomy to reduce the postoperative complaints and complications. Till date no sufficient evidence has been reported regarding effectiveness of chest binder on kinesiophobia in CABG patients post median sternotomy. Purpose: To assess the effect of chest binder on the level of kinesiophobia; in CABG patients over a period of one month. Participants: Total 70 (50 – males; 20 – females) post CABG via median sternotomy, hemodynamically stable patients, aged between 40 – 70 years, with Tampa Scale for kinesiophobia – short version (TSK – SV) Heart scores > 37 were included. Methods: On the 4th post operative day, patients were assessed for level of kinesiophobia using TSK – SV Heart. The patients were divided in to two groups depending on the prescription of chest binder by their surgeons as Group A (with binder), Group B (without binder). One month post CABG, the patients in both the groups were asked to fill the TSK – SV Heart, via telephonic conversation. Analysis: Comparison of TSK – SV Heart score at baseline and after one month within Group A and Group B was done using Wilcoxon signed rank test with continuity correction. Comparison of difference of TSK – SV Heart score at baseline and after one month between Group A and Group B was done using Mann – Whitney test. The p value < 0.05 was considered to be statistically significant. Results: The mean of TSK –SV Heart score on 4th day post CABG in group A and group B was 43.42 (±7.717) and 43.45 (±4.64) respectively. The mean of TSK –SV Heart score on one month post CABG in group A and group B was 35.82 (±8.372) and 39.51 (± 6.03) respectively. A significant reduction in kinesiophobia was observed in group A and group B, p-value 0.00001188 and 0.00007886 respectively. The 95% Confidence Interval (CI) median estimate of group A and group B was 7.9 (5.0 – 10.5) and 4.5 (3.0 – 6.0) respectively. The mean of difference of TSK – SV Heart score in group A and group B was 7.6 (±8.24) and 3.94 (±4.82) respectively. The reduction in kinesiophobia in group A was significantly more than in group B, p-value = 0.00792. The 95% Confidence Interval (CI) median estimate of the mean of difference of TSK – SV Heart score in group A and group B was 3.7 (2.48 – 4.92) Conclusion: There was significant reduction in kinesiophobia irrespective of the use of chest binder post CABG via median sternotomy over a period of one month. There was marked reduction in kinesiophobia in patients who were using chest binder. Implications: Use of chest binder is recommended in patients who have kinesiophobia to encourage their participation in exercise based cardiac rehabilitation.