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Category: Volume 4 Issue 06 June 2016
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Title: The Effect of Transcutaneous Electrical Nerve Stimulation on Forced Vital Capacity and Pain in Patients with Median Sternotomy

Authors: V.Kiran, A.Thiruppathi, Dr.C.Kodhandapani, T.Ravi Raj Kumar

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i6.41

Abstract

Background: Median sternotomy is the thoracic incision through the midline of the sternum, which is used to gain access to the heart and mediastinal structures. A significant reduction in lung volumes were reported in patients after Median Sternotomy performed during cardiac surgery.  Pain is considered as one of the most relevant factor influencing the reduction of lung volume. Subsequently, abnormalities in the chest wall mechanics may also occur that may influence the reduced lung function. TENS is a low frequency modality used to relieve pain and is been reported to be effective in reducing post-operative pain and improving lung function.

Specific Objective - To determine the effect of Transcutaneous Electrical Nerve Stimulation on Forced Vital Capacity and Pain in patients with Median sternotomy.

Methods:

Design – Pre test – Post test with Comparison group (Quasi experimental design).

Study Setting - Department of Cardio Thoracic and Vascular Surgery, Narayana Medical College And Hospital.

Participants - A total of 30 patients who underwent Median sternotomy for open heart surgeries.

Intervention - Group A-15 participants received TENS and conventional physiotherapy (duration of  20 minutes of TENS and 30 minutes of conventional physiotherapy/session for 2 sessions/ day) and Group B-15 Participants received conventional physiotherapy (30 minutes of conventional physiotherapy/ session for 2 sessions/day) for 5 days.

Outcome Measures - FVC using Hand Held Spirometer, Numerical pain rating scale and X-ray grading for Atelectasis.

Results - The patients in TENS with conventional physiotherapy group, showing the mean difference in FVC, Pain and Atelectasis were 0.85, 5.40 and 1.66 respectively. The patients with conventional physiotherapy alone, showing the mean difference of FVC, Pain and Atelectasis were 0.43, 3.53 and 1.13 respectively The FVC of patients in TENS with conventional physiotherapy and Conventional physiotherapy alone showed a mean difference of 0.42. Pain in TENS with conventional physiotherapy and conventional physiotherapy alone showed a mean difference of 1.87 and Atelectasis in TENS with conventional physiotherapy and conventional physiotherapy showed a mean difference of 0.53 using Independent’t’ test.

Conclusion - This study reveals that there was significant difference of improvement in FVC and Pain following TENS with conventional physiotherapy when compared to Conventional physiotherapy alone in patients undergoing Median sternotomy.

Key words: CABG, TENS, FVC and VAS

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Corresponding Author

V.Kiran

M.P.T Cardio, Professor

Department of Physiotherapy, Narayana College of Physiotherapy