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Cardiac rehab

Gentle Post-Surgical Strength (Sternal Precautions)

A supervised strength cardiac rehab program for adults recovering after open-heart surgery, safely rebuilding muscle while carefully following sternal precautions.

Phase: I
Functional level: Very low, Low
Risk: Low, Moderate

Program overview

Crafted for phase 2 (outpatient) cardiac rehab patients recovering from sternotomy surgery with sternal precautions, this program generally covers the initial 1–2 months post-op.

Designed specifically for patients with low-to-moderate functional levels and low-to-moderate risk stratification, it emphasizes strength and resistance training to safely rebuild muscular strength and endurance while respecting sternal precautions. The plan begins with basic equipment (bands, light dumbbells) and advances gradually to moderate-progressive loads (moderate dumbbells), following a beginner-level progression.

With bi-weekly advancements, the program offers whole-body strengthening (lower and upper body) while carefully introducing safe chest stretching and strengthening exercises at appropriate stages. Delivered in a supervised in-clinic CR setting for adults (18–75), the structured approach ensures safe sternum recovery, restores strength, and builds confidence through controlled movements under expert guidance, preparing participants for long-term wellness.

Additionally, a special one-week protocol is available for the rare instances when patients begin cardiac rehab earlier than one month post-op.

Dumbbells, Resistance Bands
Cardiovascular health, Improve function

Exercise program details

Breakdown and suggested frequency

“Early Entry to CR <1 month post-op” Weeks 1+
Gentle seated exercises focusing on lower body strength and upper body range of motion, respecting sternal precautions.

  • Intensity: RPE: 9-11, HRR: 20-40%
  • Frequency: 3-5 sessions/week
  • Duration: 10-14 min

Weeks 1-2
Supported standing exercises with bodyweight movements including gentle upper body strengthening with light resistance bands, maintaining sternal precautions.

  • Intensity: RPE: 9-11, HRR: 20-40%
  • Frequency: 2-3 sessions/week
  • Duration: 10-12 min

Weeks 3-4
Increased standing reps that include light dumbbell and moderate resistance with bands, within sternal limits. Introducing very light chest stretching and strengthening.

  • Intensity: RPE: 10-12, HRR: 20-40%
  • Frequency: 2-3 sessions/week
  • Duration: 10-14 min

Weeks 5-6
Progressive upper and lower body strength with structured resistance adjustments, minimal assistance. Chest strengthening progressing to light-moderate levels.

  • Intensity: RPE: 11-13, HRR: 30-50%
  • Frequency: 2-3 sessions/week
  • Duration: 10-14 min

Weeks 7+
Strengthening exercises that include relatively more progressive dumbbell and bodyweight exercises as sternal precautions begin to become less and less.

  • Intensity: RPE: 11-13, HRR: 30-50%
  • Frequency: 2-3 sessions/week
  • Duration: 10-14 min

Alignment with AACVPR/ACSM Guidelines: This Phase 2 program starts with low-intensity resistance (RPE 9-11, HRR 20-40%) and progresses to moderate (RPE 11-13, HRR 30-50%), adhering to outpatient guidelines for low-moderate functioning patients with sternal precautions. The major focus is frequency (2-3 sessions/week), sets (1-3), and repetitions (10-20) to support safe strength gains, with 3-5-min warm-ups (RPE 8-11) and a 3-5-min cool-down (RPE 8-9) meeting prep/recovery standards.

Updated Feb 26, 2026

Preview the 6 exercise plans
Fully preview all of the exercise plans in this exercise program before adding it to your Train account
P2 Wk 1+: Early to CR Strength
P2 Wk 1+: Early to CR Strength 8 min · Calves, Glutes & Hip flexors, Hamstrings, Quadriceps...
P2 Wk1-2: Back to Strength Basics (1-2mo Post)
P2 Wk1-2: Back to Strength Basics (1-2mo Post) 10 min · Calves, Hamstrings, Quadriceps, Ankles...
P2 Wk3-4: Back to Strength Basics (1-2mo Post)
P2 Wk3-4: Back to Strength Basics (1-2mo Post) 11 min · Calves, Glutes & Hip flexors, Quadriceps, Upper Back...
P2 Wk5-6: Back to Strength Basics (1-2mo Post)
P2 Wk5-6: Back to Strength Basics (1-2mo Post) 12 min · Arms, Back, Cardio, Chest...
P2 Wk7-8: Back to Strength Basics (1-2mo Post)
P2 Wk7-8: Back to Strength Basics (1-2mo Post) 12 min · Abs, Arms, Back, Chest...
Cool-Down Stretching Routine
Cool-Down Stretching Routine 9 min · Lower Back, Upper Back, Ankles, Legs...
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Cardiac rehab programs are developed in alignment with current AACVPR and ACSM guidance. The goal is to provide structured, evidence-informed foundations that reflect real-world clinical practice.
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