Effect of Combined Breathing Control, Pain Management, and Strengthening Exercises in Tuberculous Meningitis: A Case Report

Abstract

Background: Tuberculous meningitis (TBM) is a severe form of extrapulmonary tuberculosis that often leads to long-term neurological and functional impairments. Physiotherapy plays a crucial role in optimizing respiratory function and improving functional capacity in patients with TBM sequelae.

Objective: This case report aimed to evaluate the potential effectiveness of combined breathing control, pain management exercise, and strengthening exercise in improving respiratory and functional outcomes in a patient with TBM.

Methods: A case report was conducted on a 22-year-old female patient undergoing physiotherapy in a medical rehabilitation setting. The intervention consisted of breathing control (pursed-lip breathing and deep breathing), pain management exercise (relaxation positioning, gentle stretching, and postural correction), and strengthening exercises (bridging, straight leg raise, and isometric quadriceps). The program was administered over three sessions. Outcomes included dyspnea (Modified Medical Research Council scale), pain (Numeric Rating Scale), thoracic expansion, respiratory rate, and muscle strength (Manual Muscle Testing).

Results: After three sessions, dyspnea decreased from mMRC grade 3 to 2, pain reduced from 5/10 to 3/10 (40% reduction), respiratory rate improved from 27 to 22 breaths/min, and muscle strength increased from 3/5 to 4/5. Thoracic expansion improved across all measurement points. No adverse events were reported.

Conclusion: This case suggests that a combination of breathing control, pain management, and strengthening exercises may be beneficial in improving respiratory function and functional capacity in patients with TBM. Further studies with larger samples are required.