Less Fear, Better Function: The Impact of Minimally Invasive Cardiac Surgery on Kinesiophobia and Functional Capacity Compared to Median Sternotomy

Abstract

Introduction The comparative impact of Minimally Invasive Cardiac Surgery versus median sternotomy on the interplay between peripheral muscle strength, kinesiophobia, and functional capacity remains unclear. This study compared these parameters in the early postoperative period.Methods Forty-six patients (30 Sternotomy, 16 Minimally Invasive Cardiac Surgery) were included in this prospective study. Peripheral muscle strength (handgrip and knee extension), functional capacity (30-Second Sit-to-Stand test), and kinesiophobia (Tampa Kinesiophobia Scale) were assessed preoperatively and on the postoperative 5th day.Results Both groups experienced a significant decline in postoperative muscle strength from baseline; however, there was no statistically significant difference between the groups regarding the magnitude of this decline (e.g., right handgrip p = 0.366, right knee extension p = 0.294). However, the Minimally Invasive Cardiac Surgery group demonstrated superior functional performance in the 30-Second Sit-to-Stand test (p = 0.008) and significantly lower increases in kinesiophobia scores compared to the sternotomy group (p = 0.008). A significant negative correlation was found between kinesiophobia and functional capacity (r = -0.311, p = 0.035).Conclusion Although Minimally Invasive Cardiac Surgery does not mitigate surgery-associated muscle strength decline, it offers a distinct advantage in preserving functional capacity by minimizing kinesiophobia. Functional limitations after sternotomy appear driven more by movement-related fear than muscle weakness. Consequently, rehabilitation strategies should integrate kinesiophobia management to optimize early mobilization and functional independence.Clinical trail registration ClinicalTrials.gov, identifier (NCT07172529).