This site is not optimized for Internet Explorer 8 (or older).

Please upgrade to a newer version of Internet Explorer or use an alternate browser such as Chrome or Firefox.

Goodbye Sternal Precautions, Hello Move in the Tube?

Thursday, April 18, 2019

Ley J, El-Ansary D, Katijjahbe MA, Adams J, Triano S, Gach R. Goodbye Sternal Precautions, Hello Move in the Tube? April 2019. doi:10.25373/ctsnet.8001731.

Filmed at the 2018 EACTS Annual Meeting in Milan, Italy, Jill Ley of California Pacific Medical Center in San Francisco, USA, moderates a discussion on evidence-based recommendations for movement following sternotomy. Ms Ley is joined by Doa El-Ansary of Swinburne University of Technology and the University of Melbourne in Australia, Katijjahbe Mohd of Hospital Canselor in Malaysia, Jenny Adams of Baylor University Medical Center in Dallas, Texas, USA, Susan Triano of Memorial Healthcare System in Hollywood, Florida, USA, and Richard Gach, also of Memorial Healthcare System. The panelists discuss the origin of sternal precautions, the variability in how they are defined, and recent randomized research that investigates for safe and mindful movement that promotes active patient participation in physical activity (Katijjahbe MA, et al. 2018). They highlight an approach to defining safe movement called Move in the Tube (Adams J, et al. 2016), and they share stories of how the implementation of this approach has impacted patients.

References and Additional Resouces

Adams J, Lotshaw A, Exum E, et al. An alternative approach to prescribing sternal precautions after median sternotomy, "Keep Your Move in the Tube". Proc (Bayl Univ Med Cent). 2016;29(1):97-100.

Balachandran S, Lee A, Royse A, Denehy L, El-Ansary D. Upper limb exercise prescription following cardiac surgery via median sternotomy: a web survey. J Cardiopulm Rehabil Prev. 2014;34(6):390-395.

Balachandran S, Lee A, Denehy L, et al. Risk factors for sternal complications after cardiac operations: a systematic review. Ann Thorac Surg. 2016;102(6):2109-2117.

El-Ansary D, Adams J, Gach R, Triano S, Katijjahbe M. “Keep your Move in the Tube” after heart surgery: evidence, translation and implementation of a paradigm shift towards physical activity for enhanced recovery. EACTS Daily News, 32nd EACTS Annual Meeting. October 20, 2018:28.

Katijjahbe MA, Granger CL, Denehy L, et al. Standard restrictive sternal precautions and modified sternal precautions had similar effects in people after cardiac surgery via median sternotomy ('SMART' Trial): a randomised trial. J Physiother. 2018;64(2):97-106.


This video summarises research to support the translation of a paradigm shift from sternal precautions towards proactive physical activity for patient engagement and enhanced recovery after cardiac surgery . This was presented at the EACTS meeting in Milan, 2018.

Add comment

Log in or register to post comments