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OBJECTIVE Guidelines following median sternotomy typically include strict sternal precautions (SP). Recently, alternative approaches propose less functional restrictions while avoiding excessive stress to the sternum. The study aimed to determine the effect of a less restrictive (LR) approach versus a standard sternal precautions protocol after median sternotomy. METHODS The study was a cross-sectional design (n = 364; SP n = 172, 66.3 ± 11.2 y; LR n = 196, 65.2 ± 11.2 y). This study ran in 2 consecutive phases and compared 2 groups po