The main aim of this study is to investigate the effectiveness of Myofascial release in patients with chronic sternotomy pain.
Chronic Post-sternotomy pain (CPSP), defined as discomfort at the thorax after cardiac surgery, persisting for at least 2 months, and without apparent cause (I.e., such as infection or the underlying disease that motivated the surgery).
Age between 55 to 65 years old.
All patients will be under full medical supervision.
Adherence to informed consent.
Neuromuscular disorders.
Any Active hemorrhage.
The presence of an unstable cardiac, pulmonary or cerebral pathology.
Poor cognition and mentality.
Parallel
Myofascial release
Other interventionThe experimental group will undergo a 5-day consecutive myofascial release treatment, administered as Osteopathic Manipulative Treatment (OMT), with each session lasting a maximum of 15 minutes. The treatment will consist of three phases targeting the entire mediastinum: Thoracic Inlet (Indirect) Myofascial Release, Rib Raising with continued stretch of the paraspinal muscles to the L2 vertebral level, and Soft Tissue Cervical Paraspinal Muscle Stretch with Suboccipital Muscle Release. Participants will be positioned in a supine posture to enhance diaphragmatic excursion, with each session following a fixed, prearranged sequence of these techniques.
Breathing exercises
Other interventionFollowing the 3 phases of myofascial release, breathing exercises will be done for patients.
Pharmacological treatment
DrugPatients will take pharmacological treatment prescribed by the cardiologist.
Visual analog scale (VAS)
Scores are based on self-reported measures of symptoms that are recorded with a single handwritten mark placed at one point along the length of a 10-cm line that represents a continuum between the two ends of the scale-"no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm).
Upper chest expansion
It will be obtained by subtracting the inspiratory diameter from the expiratory diameter, according to the designated anatomical markers.
Lower chest expansion
It will be obtained by subtracting the inspiratory diameter from the expiratory diameter, according to the designated anatomical markers.
Pressure pain threshold
Pressure algometers are useful for quantifying the pressure pain thresholds of muscles. The pressure pain threshold of a patient is judged to be abnormal when the pressure pain threshold was lower than the normal value or if the pressure pain threshold of a certain site was lower than that of the opposite site by at least 2 kg/cm2, or if it was less than 3 kg/cm2.
Forced vital capacity (FVC)
It will be assessed by a spirometer before and after treatment. The patient will be asked to take a deep inspiration to expire forcefully and rapidly as much as possible through the mouthpiece.
Forced expiratory volume at one second (FEV1)
It will be assessed by a spirometer before and after treatment. The patient will be asked to take a deep inspiration to expire forcefully and rapidly as much as possible through the mouthpiece.
FEV1/FVC
The ratio between the forced expiratory volume at one second (FEV1) and forced vital capacity (FVC) will be calculated before and after treatment.
6-min walk test (6 MWT)
The total distance walked in meters will be measured.
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