The eligibility of the participants will be taken on the basis of the inclusion criteria of this research study. The informed consent will be taken from 60 subjects that will be selected according to the inclusion criteria.

Pre-Operative Procedure:- All the patients who will be involved in the study will be given consent form for their willingness to participate in the study. 

The demographic data of the patient will be taken pre-operatively. 

The patients will be instructed and taught about the Bensons relaxation technique that contains all the breathing techniques.

The patients will be taught about arm ergometer and its significance.

Post-Operative Procedure:- Post-operative program will be started after the patient will be extubated from the mechanical ventilator. 

The patient must be hemodinamically stable from the first day till the day of discharge from CTVS at least for 7 days after the surgery (post-operatively)

The pain levels of the patient will be assessed using Numeric Pain Rating Scale (NPRS) after surgery at day 1 and day 7.

The patient’s inspiratory and expiratory capacity will be measured using 3-ball incentive spirometer and quality of life will be assessed using SF-36 questionnaire on day 1 and then on day 7.

Treatment Protocol:

Warm-up exercises: Breathing exercises (Diaphragmatic breathing and pursed lip breathing) followed by gentle movements of upper limb (shoulder shrugs, elbow movements, wrist pumps).

To initiate the arm ergometer post-operative day 1, we will follow the FITT principle for exercise prescription as follows:

Frequency: We will give two sessions per day.

Intensity: The intensity will be low to moderate with no resistance. Monitor heart rate (aim for 40-50% of heart rate reserve) and ensure it stays within the prescribed limits.

Time: We will begin with exercise using arm ergometer as tolerable to the patient.

Type: We will use an arm ergometer for cardiovascular exercise and emphasize controlled and smooth movements to avoid excessive strain. We will include both forward and backward pedalling as well as proper body positioning.

To initiate the Benson Relaxation Response, we will take the following steps:

Take a comfortable seat and sit quietly.

Close your eyes.

Let all of your muscles relax fully.

Inhale via your nose. Pay attention to how you breathe. Say the word "ONE" to yourself in silence as you exhale. Take a breath, for instance, IN and OUT, "ONE": IN and OUT, "ONE": etc. Inhale smoothly and instinctively.

Keep going for ten to twenty minutes. To check the time, you can open your eyes, but avoid setting an alarm. After you are done, take a few minutes to sit quietly, first with your eyes closed and then with them open. Keep down your feet for a few minutes.