{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T17:10:46Z","timestamp":1792343446114,"version":"4.4.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T00:00:00Z","timestamp":1534118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Existing variation has been identified in the rehabilitation programs for patients following cardiac surgery. Sternal precautions are believed to be overly restrictive and detrimental to patient recovery both physically and psychologically.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The objective of this study was to determine the deformation of sternal skin during shoulder movements and upper extremity activities using a noncontact approach.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This was a cross-sectional, nonexperimental observational study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Two black dots were marked on participants\u2019 skin overlying sternoclavicular joints using an erasable marker. The coordinates of the dots were recorded using a digital camera and obtained using ImageJ, a public domain image processing program. Skin deformation between the 2 dots was quantified as biomechanical strain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The sternal skin strain was \u2212 15.3% (SD = 5.6) and \u2212 12.0% (SD = 7.0) at 90 and 180 degrees of flexion; 0.0% (SD=0.0) and\u221212.8% (SD=5.8) at 90 and 180 degrees of abduction; and \u2212 6.4% (SD=2.8), \u2212 8.9% (SD=3.8), and \u2212 9.8% (SD=4.6) when lifting the 0-, 5-, and 10-lb weights, respectively. The sternal skin strain was 7.9% (SD=3.9) for extension to the end range and\u22122.5% (SD=5.8) for pushing up from a chair. There is a trend of strain magnitude decrease with the increase of rhomboid strength, but no statistically significant association was found between them (R=0.12).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>Limitations included convenience sampling, small sample size, and using skin deformation as a proxy for mechanical loading of the bony structures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The data do not support the restriction on most of the shoulder movements and upper extremity activities following cardiac surgery. The approach has the advantage of measuring skin deformation in the entire sternal region.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzy089","type":"journal-article","created":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T03:16:53Z","timestamp":1533093413000},"page":"911-917","source":"Crossref","is-referenced-by-count":4,"title":["Noncontact Measurement of the Deformation of Sternal Skin During Shoulder Movements and Upper Extremity Activities Restricted by Sternal Precautions"],"prefix":"10.1093","volume":"98","author":[{"given":"Weiqing","family":"Ge","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Youngstown State University, One University Plaza, Youngstown, OH 44555 (USA)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Hians","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Youngstown State University; and Premier Therapy, Beaver Falls, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Sfara","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Youngstown State University; and Anchor Health and Rehabilitation, Aiken, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,8,13]]},"reference":[{"key":"2023011807561840600_bib1","article-title":"Strike While the Iron Is Hot","volume-title":"Maley Lecture, American Physical Therapy Association 2017 NEXT Conference and Exposition","author":"Manal","year":"2017","edition":"The 22nd"},{"key":"2023011807561840600_bib2","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/HCR.0000000000000053","article-title":"Upper limb exercise prescription following cardiac surgery via median sternotomy: a web survey","volume":"34","author":"Balachandran","year":"2014","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2023011807561840600_bib3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/01823246-201122010-00002","article-title":"Sternal precautions: is it time for change? 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