Early supervised incremental resistance training versus standard care following median sternotomy—A preliminary analysis of randomized controlled trial

This study reported the preliminary analysis of a Phase II prospective, double‑blind, randomized controlled trial that tested the Early Supervised Incremental Resistance Training (ESpIRiT) intervention following median sternotomy, and explored its effects on upper limb function and patient‑reported pain at four weeks and three months. Primary outcomes were safety(defined by sternal wound complications); feasibility(assessed by recruitment and adherence; and upper limb function measured by the Unsupported Upper Limb Exercise Test(UULEX). Secondary outcomes included the Functional Difficulty Questionnaire Shortened Version(FDQ‑s) and pain using the Numeric Rating Scale(NSR). Assessments occurred at baseline, discharge, four weeks, and three months postoperatively. Fifty‑five participants were recruited(ESpIRiT n = 27; standard care n = 28). No sternal complications occurred(RR 0.963, 95% CI 0.057-16.21). Adherence was 80%, with no dropouts. Between‑group differences in UULEX were not significant at four weeks(MD 1.49, 95% CI -4.62 to 7.16) or three months(MD 1.19, 95% CI -5.58 to 7.79). No significant differences were found for FDQ‑s or NSR. Within‑group analyses showed significant improvements in UULEX, FDQ‑s, and NSR over time. ESpIRiT was safe, feasible, and well‑accepted in the acute inpatient setting, with strong recruitment, adherence, and no adverse events. Trial registration: ISRCTN 17842822, registered 11 March 2020.