Physiotherapy Management of Post-Tuberculosis Lung Disease with Cardiopulmonary Comorbidity: A Case Report

Abstract

Background: Post-tuberculosis lung disease (PTLD) is associated with persistent respiratory impairment, which may be exacerbated by cardiopulmonary comorbidities such as cardiomegaly and pleural effusion. These conditions contribute to dyspnea, reduced thoracic expansion, and limited functional capacity. Physiotherapy plays an important role in improving respiratory efficiency and functional performance.

Objective: To provide clinically relevant insight into physiotherapy management in a patient with PTLD and cardiopulmonary comorbidity.

Methods: This study was a single-case report based on a clinical physiotherapy record. A 59-year-old male presented with a 3-month history of persistent cough, dyspnea, and difficulty expectorating sputum. Assessment included physical examination, thoracic expansion measurement, Borg Dyspnea Scale, modified Medical Research Council (mMRC), vital signs, chest radiography, laboratory findings, and medication review. The intervention consisted of nebulizer therapy, breathing exercises, and chest mobility exercises with symptom-based progression. Clinical outcomes were monitored descriptively across six sessions.

Results: Baseline findings showed respiratory rate 24 breaths/min, heart rate 108 beats/min, thoracic expansion 2.0–2.1 cm, mMRC grade 2, and walking tolerance <10 m. Across six sessions, respiratory rate decreased from 24 to 20 breaths/min and heart rate from 108 to 92 beats/min. Thoracic expansion improved from 2.0–2.1 cm to 2.4–2.5 cm. Blood pressure remained stable. These changes indicate a clinically meaningful improvement in breathing control and chest wall mobility.

Conclusion: Individualized physiotherapy incorporating breathing exercises, chest mobility training, and graded functional activity may improve respiratory parameters and functional tolerance in patients with PTLD and cardiopulmonary comorbidity.