Patients often need to use their arms to assist with functional activities, but after open heart surgery, pushing with the arms is limited to <10 lb (4.5 kg) to help minimize force across the healing sternum. The main purposes of this study were to determine if older patients (>60 years old) (1) accurately estimated upper extremity (UE) weight bearing force of 10 lb or less and (2) if feedback training improved their ability to limit UE force and pectoralis major muscle contraction during functional activities. An instrumented walker was used to measure UE weight bearing force, and electromyography was used to measure pectoralis major muscle activity simultaneously during 4 functional mobility tasks. After baseline testing, healthy older subjects (n = 30) completed a brief session of visual and auditory concurrent feedback training. Results showed that the self-selected UE force was >10 lb for all tasks (20.0-39.7 lb [9.1-18.0 kg]), but after feedback training, it was significantly reduced (10.6-21.3 lb [4.8-9.7 kg]). During most trials (92%), study participants used >12 lb (5.5 kg) of arm weight bearing force. Pectoralis major muscle peak electromyography activity was <23% of maximal voluntary isometric contraction and was reduced (9.8-14.9%) after feedback training. Older patients may not be able to accurately estimate UE arm force used during weight bearing activities, and visual and auditory feedback improves accuracy and also modulation of pectoralis major muscle activation. Results suggest that an instrumented walker and feedback training could be clinically useful for older patients recovering from open heart surgery.

中文翻译：

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反馈培训可改善功能性活动期间对胸骨预防原则的依从性：对中位胸骨切开术后老年患者优化康复的意义。

患者通常需要使用手臂来辅助功能性活动，但是在进行心脏直视手术后，手臂的推力被限制在<10磅（4.5公斤）以帮助最小化横跨胸骨的力。这项研究的主要目的是确定年龄较大的患者（> 60岁）（1）是否准确估计上肢（UE）的承重力为10 lb或更小;（2）反馈训练是否提高了他们限制UE力量的能力功能活动期间胸大肌收缩。在4个功能性活动任务中，使用仪器助行器测量UE的承重力，并使用肌电图同时测量胸大肌的活动。经过基线测试后，健康的老年受试者（n = 30）完成了简短的视觉和听觉并发反馈培训课程。结果显示，对于所有任务，自选UE力均大于10磅（20.0-39.7磅[9.1-18.0千克]），但在反馈训练后，其显着降低（10.6-21.3磅[4.8-9.7千克]） 。在大多数试验（92％）中，研究参与者使用了大于12磅（5.5千克）的手臂负重力。胸大肌的峰值肌电图活动小于最大自愿等距收缩的23％，并在反馈训练后降低（9.8-14.9％）。老年患者可能无法准确估计负重活动期间使用的UE臂力，并且视觉和听觉反馈可提高准确性以及胸大肌激活的调节。结果表明，仪器化的助行器和反馈训练对于从心脏直视手术中康复的老年患者可能在临床上有用。