Early Cardiopulmonary Rehabilitation After MVR and TVr in Pulmonary Tuberculosis: A Case Report

Nugraha Satya Ramadhan; Agus Widodo; Purnomo Gani; Diani Qomaradewi Indah Sari

doi:10.24843/

Penulis

Nugraha Satya Ramadhan Department of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia Penulis
Agus Widodo Physiotherapy Professional Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia Penulis
Purnomo Gani Department of Physical Medicine and Rehabilitation, Dr. Kariadi Central General Hospital, Semarang, Indonesia Penulis
Diani Qomaradewi Indah Sari Department of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia Penulis

DOI:

https://doi.org/10.24843/

Kata Kunci:

Cardiac Rehabilitation, Early Ambulation, Mitral Valve Replacement, Physical Therapy Modalities, Tuberculosis, Pulmonary, Tricuspid Valve Repair

Abstrak

Background: Early cardiopulmonary rehabilitation after cardiac valve surgery is important to reduce pulmonary complications and functional decline. Patients with pulmonary tuberculosis may present impaired pulmonary reserve and reduced exercise tolerance that complicate postoperative recovery after Mitral Valve Replacement (MVR) and Tricuspid Valve Repair (TVr). Evidence regarding rehabilitation in this clinical combination remains limited. This report followed the CARE guideline.
Objective: To describe the safety and short-term outcomes of early cardiopulmonary rehabilitation after MVR and TVr in a patient with pulmonary tuberculosis.
Methods: A 23-year-old male on postoperative day seven after MVR and TVr via median sternotomy underwent rehabilitation based on the Frequency, Intensity, Time, and Type (FITT) principle. Interventions included breathing exercise, airway clearance, incentive spirometry, active-assisted range of motion exercise, and progressive mobilization. Sessions lasted 30–45 minutes across three treatment sessions. Outcomes included chest expansion, Numeric Rating Scale (NRS), Borg Rating of Perceived Exertion (RPE), Barthel Index, oxygen requirement, and vital signs.
Results: Chest expansion improved from 2.0 cm to 3.5 cm, Borg RPE decreased from 13 to 9, movement pain decreased from NRS 6 to 2, and Barthel Index improved from 65 to 80. Oxygen supplementation was reduced from 3 L/min nasal cannula to room air while SpO₂ remained ≥97%. No adverse events or hemodynamic instability occurred during intervention.
Conclusion: Early cardiopulmonary rehabilitation was safely tolerated and associated with improved respiratory and functional outcomes during acute postoperative recovery. However, these findings represent preliminary evidence from a single-case report without long-term follow-up or objective pulmonary function testing.