Physiotherapy Management of Grade III Pressure Ulcer: A Case Report

Qori'ah Titin Masyitoh; Arin Supriyadi; Made Pradnya Paramita

doi:10.24843/mifi.000001777

Authors

Qori'ah Titin Masyitoh Physiotherapy Professional Education Program, Universitas Muhammadiyah Surakarta, Indonesia Author
Arin Supriyadi Department of Physiotherapy, Universitas Muhammadiyah Surakarta, Indonesia Author
Made Pradnya Paramita RSUP Prof. Dr. I.G.N.G. Ngoerah Bali, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001777

Keywords:

Pressure Ulcer, Physical Therapy Modalities, Immobility, Range of Motion, Case Reports

Abstract

Background: Pressure ulcers are common complications in patients with prolonged immobility and significantly impair rehabilitation outcomes and quality of life.

Objective: This study aimed to describe the effects of physiotherapy management in a patient with a grade III pressure ulcer in the sacral and gluteal regions.

Methods: This case report followed CARE guidelines and involved a 45-year-old male with stage IVB lung adenocarcinoma and upper motor neuron (UMN) paraparesis. Physiotherapy assessment included Numeric Rating Scale (NRS), range of motion (ROM), Manual Muscle Testing (MMT), Modified Ashworth Scale (MAS), Braden Scale, and wound inspection. The intervention consisted of three sessions including passive range of motion (PROM), active-assisted range of motion (AAROM), bed mobility training, low-intensity stretching, positioning strategies, and caregiver education.

Results: The patient presented with a grade III pressure ulcer measuring 5 × 3 cm with slough, exudate, and pus. Pain during movement decreased from NRS 2 to 1 (50% reduction), while tenderness decreased from 3 to 2 (33% reduction). ROM showed slight improvements in shoulder flexion (increase up to 3°). Muscle strength (MMT = 2 in upper limbs; 0 in lower limbs) and spasticity (MAS = 1+) remained unchanged. No progression in ulcer grade was observed during the intervention period.

Conclusion: Physiotherapy contributed to pain reduction, maintenance of joint mobility, and prevention of secondary complications. However, due to the short intervention duration and complex medical condition, no improvement in ulcer grade was observed.