Combined Institutional and Telerehabilitation Programs for A Post-Tuberculosis Lung Disease Patient with Low Cardiorespiratory Endurance: A Case Report
DOI:
https://doi.org/10.36497//jri.v45i4.719Keywords:
cardiorespiratory endurance, chronic respiratory diseases, pulmonary rehabilitation, tuberculosisAbstract
Background: Post-tuberculosis lung disease (PTLD) can lead to long-term respiratory issues and impaired lung function, which can impact quality of life. Pulmonary rehabilitation (PR) is a personalized strategy designed to address these problems and improve overall well-being. It is administered by a diverse team of experts.
Case: A 28-year-old female patient with a history of tuberculosis (TB) presented with breathing difficulty. The physical examination revealed decreased chest expansion, shoulder asymmetry, a slight forward neck, and a rounded shoulder. The radiologic findings and bronchoscopy showed PTLD, atelectasis in several parts of the right lung, and regional destruction of the right lung.
Discussion: The patient underwent pulmonary rehabilitation (PR), which included endurance exercises, strength training, several types of breathing exercises, breath-stacking exercises, thoracic expansion exercises, physical agents for rehabilitation modalities, education on posture correction, and energy conservation in daily activities. The patient was also monitored remotely through telerehabilitation from home. There were significant improvements in pulmonary function tests. Measurement of FVC, FEV1, the six-minute walking test (6MWT), and the PCF after two weeks of follow-up. After eight weeks of training, there were improvements in cardiopulmonary endurance, muscle endurance, and reduced dyspnea.
Conclusion: Comprehensive pulmonary rehabilitation programs, including a combination of institutional and telerehabilitation synchronous approaches, can help improve cardiopulmonary endurance, muscle strength-endurance, and the overall patient's functional life who was suffering from chronic respiratory diseases, such as post-TB sequelae.
Downloads
References
1. Dodd PJ, Yuen CM, Jayasooriya SM, van der Zalm MM, Seddon JA. Quantifying the global number of tuberculosis survivors: A modelling study. Lancet Infect Dis. 2021;21(7):984–92.
2. Menzies NA, Quaife M, Allwood BW, Byrne AL, Coussens AK, Harries AD, et al. Lifetime burden of disease due to incident tuberculosis: A global reappraisal including post-tuberculosis sequelae. Lancet Glob Health. 2021;9(12):e1679-87.
3. Ivanova O, Hoffmann VS, Lange C, Hoelscher M, Rachow A. Post-tuberculosis lung impairment: Systematic review and meta-analysis of spirometry data from 14 621 people. European Respiratory Review. 2023;32(168):220221.
4. Ravimohan S, Kornfeld H, Weissman D, Bisson GP. Tuberculosis and lung damage: From epidemiology to pathophysiology. European Respiratory Review. 2018;27(147):170077.
5. Hasanudin H, Sukartini T, Makhfudli M, Rosyid AN, Revita NCT, Aini HN. The effectiveness of pulmonary rehabilitation on pulmonary function among adults patients of COVID-19 survivors: A systematic review. Jurnal Respirasi. 2022;8(1):15–25.
6. Visca D, Zampogna E, Sotgiu G, D’Ambrosio RCL, Saderi L, Pegoraro V, et al. Pulmonary rehabilitation is effective in patients with tuberculosis pulmonary sequelae. European Respiratory Journal. 2019;53(3):1802184.
7. Abdelaleem NA, Ahmed MK, Mohamed MN, Bayoumi HA. Lung health after tuberculosis: Clinical and functional assessment in post-pulmonary tuberculosis Egyptian patients. The Egyptian Journal of Bronchology. 2022;16:23.
8. Gai X, Allwood B, Sun Y. Post-tuberculosis lung disease and chronic obstructive pulmonary disease. Chin Med J (Engl). 2023;136(16):1923–8.
9. Hunter L, Ruedas-Torres I, Agulló-Ros I, Rayner E, Salguero FJ. Comparative pathology of experimental pulmonary tuberculosis in animal models. Front Vet Sci. 2023;10:1264833.
10. Singh S, Allwood BW, Chiyaka TL, Kleyhans L, Naidoo CC, Moodley S, et al. Immunologic and imaging signatures in post tuberculosis lung disease. Tuberculosis. 2022;136:102244.
11. Carlsen KH, Crowley S, Smevik B. Atelectasis. In: Wilmott RW, Deterding R, Li A, Ratjen F, Sly P, Zar HJ, et al., editors. Kendig’s disorders of the respiratory tract in children. 9th ed. Elsevier; 2019. p. 1027–33.
12. Marini JJ. Acute lobar atelectasis. Chest. 2019;155(5):1049–58.
13. Siti Chandra Widjanantie. Rehabilitasi respirasi sebagai bagian pentingtatalaksana penyakit paru obstruktif kronik. Journal Of The Indonesian Medical Association. 2020;69(6):209–10.
14. Kotb Tolba S, Abd El-Hady AA, Moussa H, Mohamed ME, Alaal A, Amin W, et al. Efficacy of pulmonary rehabilitation program in patients with treated pulmonary tuberculosis. Systematic Reviews in Pharmacy. 2021;12(3):516–21.
15. Mahler B, Croitoru A. Pulmonary rehabilitation and tuberculosis: A new approach for an old disease. Pneumologia. 2019;68(3):107–13.
16. Nurhasanah L, Wahyudati S. The effect of additional air stacking exercise on VO2 max: A study on elderly with restrictive pulmonary disorder who had deep breathing exercise. Mal J Med Health Sci 16(SUPP14): 66-70, Dec 2020 66Malaysian Journal of Medicine and Health Sciences. 2020;16:66–70.
17. Choi H, Yoo JE, Han K, Choi W, Rhee SY, Lee H, et al. Body mass index, diabetes, and risk of tuberculosis: A retrospective cohort study. Front Nutr. 2021;8:739766.
18. Carwile ME, Hochberg NS, Sinha P. Undernutrition is feeding the tuberculosis pandemic: A perspective. J Clin Tuberc Other Mycobact Dis. 2022;27:100311.
19. Csepregi É, Gyurcsik Z, Veres-Balajti I, Nagy AC, Szekanecz Z, Szántó S. Effects of classical breathing exercises on posture, spinal and chest mobility among female university students compared to currently popular training programs. Int J Environ Res Public Health. 2022;19(6):3728.
20. Wakde G, Patil P. Effects of pilates breathing on chest expansion, dyspnoea and functional capacity in COPD patients - An experimental study. International Journal of Research and Review. 2021;8(5):249–62.
21. Cox NS, Dal Corso S, Hansen H, McDonald CF, Hill CJ, Zanaboni P, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database of Systematic Reviews. 2021;1(1):CD013040.
22. Dai Y, Huang H, Zhang Y, He N, Shen M, Li H. The effects of telerehabilitation on physiological function and disease symptom for patients with chronic respiratory disease: A systematic review and meta-analysis. BMC Pulm Med. 2024;24(1):305.
23. Taito S, Yamauchi K, Kataoka Y. Telerehabilitation in subjects with respiratory disease: A scoping review. Respir Care. 2021;66(4):686–98.
24. Sonone S V, Bhakaney PR, Jain M, Yadav V, Vardhan VD. Inpatient pulmonary rehabilitation followed by tele-rehabilitation in a patient with post tubercular sequelae: A case study. Med Sci. 2022;26(125):ms268e2188.
25. Seo W, Kim HW, Kim JS, Min J. Long term management of people with post-tuberculosis lung disease. Korean Journal of Internal Medicine. 2024;39(1):7–24.
26. Akkerman OW, ter Beek L, Centis R, Maeurer M, Visca D, Muñoz-Torrico M, et al. Rehabilitation, optimized nutritional care, and boosting host internal milieu to improve long-term treatment outcomes in tuberculosis patients. International Journal of Infectious Diseases. 2020;92S:S10–4.
27. Allwood BW, Van Der Zalm MM, Amaral AFS, Byrne A, Datta S, Egere U, et al. Post-tuberculosis lung health: Perspectives from the First International Symposium. International Journal of Tuberculosis and Lung Disease. 2020;24(8):820–8.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Siti Chandra Widjanantie, Heidy Agustin, Diah Handayani, Erlina Burhan, Agus Dwi Susanto
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
- The authors own the copyright of published articles. Nevertheless, Jurnal Respirologi Indonesia has the first-to-publish license for the publication material.
- Jurnal Respirologi Indonesia has the right to archive, change the format and republish published articles by presenting the authors’ names.
- Articles are published electronically for open access and online for educational, research, and archiving purposes. Jurnal Respirologi Indonesia is not responsible for any copyright issues that might emerge from using any article except for the previous three purposes.
