Control of separation in sternal instability by supportive devices: a comparison of an adjustable fastening brace, compression garment, and sports tape

El-Ansary D, Waddington G, Adams R. Control of separation in sternal instability by supportive devices: a comparison of an adjustable fastening brace, compression garment and sports tape.

Objective

To evaluate the effectiveness of 3 supportive devices in controlling sternal separation.

Design

A cross-sectional, randomized intervention study.

Setting

Participants were from the general community who were referred to the study by their cardiac surgeon or cardiologist.

Participants

Fifteen patients (12 men, 3 women) between 49 and 80 years of age with sternal instability after a median sternotomy.

Interventions

Not applicable.

Main Outcome Measures

Support from sports tape, a compression garment, and an adjustable fastening brace was assessed by an ultrasound-based measure of sternal separation contingent on movement and by self-report measures of comfort, pain, feeling of support, ease of upper-limb movement, and ease of breathing.

Results

For both sternal separation and self-report data, some support was better than no support, and a supportive device worn on the body was better than sports tape. Wearing an adjustable fastening brace was better than a compression garment and, compared with no support, closed the sternal gap by 20% or 2.7mm (95% confidence interval, 1.5-3.9mm). The effects of wearing the different supportive devices on visual analog scale ratings of comfort, pain, support, ease of breathing, and movement mirrored the results obtained for sternal separation, thus providing agreement between self-report and objective measures.

Conclusions

Supportive devices may be useful in the management of patients with sternal instability because wearing one resulted in a reduction of both sternal separation and pain report after movement. The largest effect was obtained from wearing an adjustable fastening brace.