Limiting factors of early physiotherapy after cardiac surgeries are, besides various risks of circulatory complications, set by general deconditioning of patients with multiple illnesses, syndrome of painful thoracic armour and problems with unhealed operation wounds (longitudinal sternotomy, thoracostomy, sutures in graft donor sites in extremities). Significant non-cardiac pain dominates in the area of sternotomy, associated with respiratory insufficiency and risk of unstable sternum. Patients can also experience esophagus pain (GERD), segmental visceral pain with segmental propagation (Th 4-11), as well as vertebral inter- and peri-scapular pain and acral paresthesias in the upper extremities. Ergometry is, because of risk of sutures dehiscence and misinterpretation of results secondary to non-cardiac factors, possible only after surgery sites heal. The goals of physiotherapy are to achieve good activity tolerance in the level of activities of daily living and to teach patients simple technique of determination of appropriate preventative exercise. To set individually the adequate exercise level, we can use the ”speak, sing, and breathe heavily” method, set the training heart rate (THR) and limit heart rate according to approximate formula THR= (220 – age) * 0.75 or use so called Corridor walking test (CWT) and correlation between CWT/6 min and spirometric maximal O2 consumption.

        Key words: coronary revascularization, longitudinal sternotomy, prevention of unstable sternum, irritable esophagus, respiratory physiotherapy, training heart rate, Corridor walking test, Nordic walk