Overview of Cardiorespiratory Physiotherapy
Key concepts, goals, assessment tools, treatment techniques, and clinical considerations
1. Definition & Scope
- Cardiorespiratory physiotherapy focuses on the prevention, assessment, and treatment of disorders affecting the heart, lungs, and thoracic cage.
- Encompasses acute care, rehabilitation, and chronic disease management.
- Primary patient groups: postoperative cardiac surgery, chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, cystic fibrosis, neuromuscular disease, and patients on mechanical ventilation.
2. Core Objectives
| Objective |
Clinical Rationale |
| Improve ventilation‑perfusion matching |
Enhances oxygen uptake and CO₂ removal. |
| Promote airway clearance |
Reduces infection risk, improves gas exchange. |
| Increase lung volumes & capacities |
Prevents atelectasis, maintains functional residual capacity. |
| Enhance respiratory muscle performance |
Supports effective breathing and weaning from ventilation. |
| Facilitate early mobilization |
Improves cardiovascular endurance and reduces deconditioning. |
| Educate patients & caregivers |
Encourages self‑management and adherence to therapy. |
3. Assessment Framework
3.1 Subjective Evaluation
- Medical history: cardiac surgery, pulmonary disease, comorbidities, medication.
- Symptoms: dyspnea (scale: mMRC, Borg), cough, sputum characteristics, chest pain, fatigue.
- Functional limitations: ADL impact, exercise tolerance.
3.2 Objective Measures
| Parameter |
Tools/Methods |
Normal/Target Values |
| Respiratory rate (RR) |
Observation, monitor |
12–20 breaths/min |
| Oxygen saturation (SpO₂) |
Pulse oximeter |
≥ 94 % (room air) |
| Arterial blood gases (ABG) |
Blood sample |
PaO₂ > 80 mmHg, PaCO₂ ≈ 35–45 mmHg |
| Spirometry |
FEV₁, FVC, FEV₁/FVC |
≥ 80 % predicted |
| Peak cough flow |
Peak flow meter |
> 270 L/min (adequate clearance) |
| Respiratory muscle strength |
MIP/MEP, sniff nasal inspiratory pressure |
MIP ≤ ‑80 cmH₂O (men), ‑70 cmH₂O (women) |
| Functional capacity |
6‑Minute Walk Test (6MWT), Shuttle Walk Test |
6MWD > 400 m (healthy adult) |
| Chest wall motion |
Observation, thoracic excursion tape |
Symmetric expansion |
| Heart rate & rhythm |
ECG, pulse |
60–100 bpm, regular |
3.3 Clinical Decision‑Making
- Identify restrictive vs. obstructive patterns, muscle weakness, or ventilation‑perfusion mismatch.
- Prioritize interventions based on severity, risk of complications, and patient goals.
4. Treatment Modalities
4.1 Airway Clearance Techniques
| Technique |
Indication |
Key Steps |
| Chest percussion & vibration |
Secretions in dependent lung zones |
Perform 3–5 min per segment, synchronize with exhalation |
| Postural drainage |
Gravity‑assisted drainage |
Position patient 30 |