Critical review of the justification of limitations in physical therapy and activities of daily living in cardiac surgery patients

Introduction
The study aim was to analyse the justification of limitations in physical therapy and activities of daily living in patients after cardiac surgery via sternotomy.

Methods
A narrative review design was followed. This study is the result of analysing and comparing the data obtained through investigating sternal closure stability after sternotomy, the load on the sternum during physical therapy, activities of daily living and coughing, as well as the effectiveness of sternum external fixation.

Results
Sternum closure stability after sternotomy and the force of the load on the sternum during cough are greater than when performing upper extremity movements and most of the activities of daily living. The benefits of using sternum external fixation are not marked. Mathematically, most of the presented statistical benefits of sternum external fixation were achieved owing to the large number of individuals in the samples. Therefore, it is important to analyse such statistical indicators as odds ratio, attributable risk, the number needed to treat in terms of such a ‘harmful factor’ as lack of sternum external fixation. The use of sternum external fixation should be biomechanically grounded.

Conclusions
Conventional restrictions and recommendations for patients after cardiac surgery via sternotomy lack theoretical justification and research to confirm their necessity.