the aim of this study is to find out the differences between the effect of supra- abdomen exercises and the effect of infra-abdomen exercise combined with LASER And the effect of LOW LEVEL LASER only on sternal instability. Methods: 120 patients of both sexes who had acute sternal instability post-open heart surgery will be recruited in this study at Assiout University Hospitals; their ages will be \> 18 years. They will be randomly assigned into 4 equal groups: 1. Study group (A): patients will receive supra-abdominal resisted exercises combined with LLL and the traditional cardiac rehabilitation program of phase one. 2. Study group (B): patients will do infra-abdominal resisted exercises combined with LLL and the traditional cardiac rehabilitation program of phase one. 3. Study group (c): patients will receive a traditional cardiac rehabilitation pro-gram of phase one with LLL 4. Control group: patients will receive the traditional cardiac rehabilitation pro-gram of phase one only
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sternal instability
Timeframe: at baseline and after finishing program (up to one month)