Progressive Physiotherapy for Respiratory Function and Early Mobilization in ICU Pneumonia: A Case Report

Tjokorda Istri Agung Rosanthi Pradnyani; Ni Ketut Cintya Dewi; Alfioni Angleque George Putri; Ni Ketut Evitri Widhiantari; I Gede Eka Juli Prasana; Ariezta Jeviana; Dewa Ayu Kadek Purnama Dewi

doi:10.24843/mifi.000001616

Authors

Tjokorda Istri Agung Rosanthi Pradnyani Professional Physiotherapy Program, Faculty of Medicine, Universitas Udayana, Indonesia Author
Ni Ketut Cintya Dewi Professional Physiotherapy Program, Faculty of Medicine, Universitas Udayana, Indonesia Author
Alfioni Angleque George Putri Professional Physiotherapy Program, Faculty of Medicine, Universitas Udayana, Indonesia Author
Ni Ketut Evitri Widhiantari Professional Physiotherapy Program, Faculty of Medicine, Universitas Udayana, Indonesia Author
I Gede Eka Juli Prasana Department of Physiotherapy, Faculty of Medicine, Universitas Udayana, Indonesia Author
Ariezta Jeviana Physiotherapy Polyclinic, Udayana University Hospital, Indonesia Author
Dewa Ayu Kadek Purnama Dewi Physiotherapy Polyclinic, Udayana University Hospital, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001616

Keywords:

pneumonia, intensive care units, respiratory therapy, physical therapy modalities

Abstract

Background: Pneumonia in critically ill patients admitted to the intensive care unit (ICU) is commonly associated with impaired ventilation, secretion retention, and an increased risk of respiratory complications. Respiratory physiotherapy has been widely applied as a supportive intervention to enhance airway clearance and optimize ventilation.

Objective: This study aimed to evaluate respiratory outcomes and early mobilization in a patient with pneumonia receiving progressive physiotherapy from the ICU to the inpatient ward.

Methods: A single-patient case report was conducted in a 19-year-old male diagnosed with corrected metabolic acidosis, acute kidney injury, and pneumonia. The patient received six physiotherapy sessions, including three sessions in the ICU and three sessions in the inpatient ward. Interventions consisted of chest physiotherapy, thoracic mobilization, effective coughing exercises, passive to active-assisted range of motion (PROM–AAROM), infrared therapy, and positioning education. Outcome measures included vital signs, Modified Borg Scale (mBorg), thoracic expansion, capillary refill time, and ICU Mobility Scale (IMS).

Results: Respiratory rate decreased from 45 to 18 breaths per minute, accompanied by a reduction in dyspnea (mBorg score from 5 to 2). Thoracic expansion improved from 1 cm to 3 cm, while functional mobility increased (IMS score from 0 to 1). Hemodynamic parameters remained stable throughout the intervention period.

Conclusion: Progressive physiotherapy was associated with improvements in respiratory function and early mobilization in a patient with pneumonia and may be considered a supportive component in multidisciplinary management.