Physiotherapy after heart surgery focuses on provision of respiratory comfort of the patient, relaxation of postoperative respiratory rigidity and on reduction of the sensation of “thoracic armour” in patients after longitudinal sternotomy. Respiratory physiotherapy emphasizes principles of linearity during slow breathing (so-called principle of velocity). Special expectoration techniques are used (Airway clearance techniques), such as static breathing techniques, postural drainage (according to Chevaillier) and energy conserving controlled cough (huffing). After initial assisted breathing with the use of localized breathing and inhalation therapy, treatment progresses to resisted breathing. Firstly, resisted inspiration is practiced (with the device TRIFLO), then mainly resisted expiration with the use of positive expiratory pressure system with oscillation breathing (PEP devices). Physiotherapy after sternotomy starts with abdominal breathing and gradually adds costoabdominal and costal breathing.We utilize the dynamics of thoracic spine as well as upper extremities (dynamic breathing techniques). Very important is fitness training with breathing exercises and subsequent regular relaxation with the use of autogenic training.

        Key words: longitudinal sternotomy, postoperative respiratory rigidity, principles of velocity, linearity of breathing, assisted breathing, postural drainage, huffing, localized breathing,