Physiotherapy guide after Cardiac Surgery

It will provide you with generalised advice post cardiac surgery, including increasing your level of physical activity and the benefits of doing so, basic exercises you can complete yourself and advice around deep breathing exercises. Also, there are some frequently asked questions from other patients.

Why have I been discharged from physiotherapy?

The physiotherapy team have ensured that you are well following your surgery. One of our physiotherapists will have already spoken to you on the Cardiac Intensive Care Unit (CICU) and advised you on deep breathing exercises, the importance of making sure your pain is well controlled and the importance of walking regularly following surgery.
As you are following the normal pathway of recovery, we are confident you will progress back to how you were walking before the operation.

What do the physiotherapy team recommend for you?

We would recommend that you keep moving and completing your deep breathing exercises. In the first few days following your surgery, your walking will gradually progress until you become independent on the ward. The aim should be for you to walk the same distance that you would normally walk at home, on the ward.

Once you feel confident walking on your own, we encourage you to get up regularly and walk around the ward. You may feel you can walk further than this, such as going to the roof garden or the shops downstairs, but make sure to check with your nurse before you leave the ward.

“What are the deep breathing exercises?”

It is important to ensure that you are able to complete deep breathing and coughing (with or without the support of your rolled up towel). This ensures that you can expand your lungs fully. You should complete the deep breathing exercise below regularly to cough up any phlegm you may have. If you are unable, due to pain or discomfort, please let your nurse know as it is important that your pain is well controlled.

• Take a long, slow and deep breath in through your nose, breathing in fully, drawing air to the bottom of your lungs and breathe out gently (4-5 times).
• Return to normal breathing (4-5 breaths).
• Complete a ‘huff’; make your mouth into an ‘O’ shape and do a short sharp breath out. Imagine you are trying to steam up a mirror or your glasses (3-4 times).
• Complete a few strong coughs to bring up phlegm. Hold your rolled up towel across your chest for support.

“Why should I keep on moving? What are the benefits of exercise after surgery?”

• Helps expand your lungs and improves oxygen levels.
• Improves your ability to cough and reduces the risk of chest infections.
• Strengthens muscles and keeps them flexible.
• You will be able to do more with less effort as your fitness improves.
• Increases circulation to the heart and other major organs.
• Improves mood and helps you to sleep better.

“What does progress after surgery look like for me?”

Every individual’s progression looks different, the key principle to consider is that your progression is realistic, gradual and relative to you. Some ideas can include:

• Sit in your chair rather than staying in bed.
• Change into your normal clothes instead of hospital clothes.
• Increase the frequency and distance of your walks e.g., walk more than 5 times each day and try adding 5-10 metres extra each day.
• Use less or no support to complete your washing and dressing or try to get washed and dressed without any help.
• Try the exercises on the next page.

“What does progress after surgery look like for me?”

When you are walking on the ward by yourself, we would recommend these exercises below:

1. Sit to stand:

Sit in a chair. Feet on the floor, shoulder width apart. Stand up. Sit down slowly. Repeat 8-10 times, twice per day.

In order to progress this aim to stand without using your arms to help you stand from the chair.

2. Leg extension:

Sit in a chair. Slowly straighten one leg then return to starting position. Repeat 10 times per leg, twice per day.

In order to progress this exercise, try and hold your leg in the extended position for 5 -10 seconds.

“What if I have concerns about my physical abilities?”

If you have concerns about your physical ability, please speak to your nurse and they will refer you to the physiotherapist.

Alternatively, speak to one of the physiotherapists on the ward when you see them.

Frequently Asked Questions

“My pain is stopping me from coughing and moving, what can I do?”

Please ask your nurse or doctor for more pain medication. There is often extra that you can have.

“I used a zimmer frame on ICU and now I don’t have one, what should I do?”

The first time you walk after surgery, you often need a zimmer frame to help with your confidence and to hold your drips and drains. However, we do not expect you to need a zimmer frame on Ward 16. Ask your nurse to walk with you for the first time without a frame if you have any concerns. If you or your nurse think you do need to use a zimmer frame, then you need to see the physiotherapist in order to be assessed. The nursing staff can refer you, or speak to a physio on the ward.

“I see other patients with physios doing a stairs assessment, do I need to complete the stairs before I go home?”

Because you have been assessed as having no issues with your walking and because you managed the stairs well before your admission, you do not need to have a stairs assessment. However, if you have any concerns, please speak to the physiotherapy team and they will discuss this with you.

Further information

If you have any questions not covered in this booklet, please speak to a member of the ward staff.

For advice about what to do when you go home, please see the discharge booklet given to you on the ward. LN000798 ‘Your Journey Through Heart Surgery.’ Or follow the link below.