EVALUATION OF DYSPNEA, THORACIC EXPANSION, AND THE INTENSIVE CARE UNIT MOBILITY SCALE IN A PATIENT WITH PARAPNEUMONIC EFFUSION: A PHYSIOTHERAPY CASE REPORT AT HERMINA GRAND WISATA HOSPITAL

Abstract

Parapneumonic effusion is a serious pulmonary complication of pneumonia that can impair respiratory function and reduce functional capacity, particularly in patients admitted to the Intensive Care Unit (ICU). This case report aimed to evaluate dyspnea, thoracic expansion, and the Intensive Care Unit Mobility Scale (IMS) following physiotherapy interventions in a patient with parapneumonic effusion. A 56-year-old male patient was admitted to the ICU with complaints of dyspnea. Clinical findings included decreased thoracic expansion, and reduced functional ability. Initial assessment showed a Borg scale score of 3 (moderate dyspnea), thoracic expansion of 1 cm (upper), 2 cm (middle), 4 cm (lower), and IMS score of 1 indicating severe dependency. The physiotherapy program consisted of breathing exercises (control breathing and diaphragmatic breathing), chest mobility exercises and active range of motion exercises. Interventions were conducted over five treatment sessions in the ICU setting. Following intervention, improvements were observed in dyspnea (Borg scale reduced to 2), thoracic expansion (upper 3 cm, middle 4.5 cm, lower 4.5 cm), and functional mobility (IMS increased from 1 to 8). In conclusion, physiotherapy interventions play an important role in improving respiratory function, thoracic mobility, and functional capacity in ICU patients with parapneumonic effusion, thereby reducing the risk of further complications.