Efficacy of Pulmonary Rehabilitation in Pulmonary Tuberculosis Sequelae with Cystic Bronchiectasis and Pulmonary Hypertension

Abstract

Cystic bronchiectasis, also known as saccular bronchiectasis (a severe type of bronchiectasis), is a condition that occurs as a complication and sequelae after pulmonary Tuberculosis (TB). There is chronic permanent dilation of bronchi that occurs after destructive changes in elastic and muscular layers of bronchial walls which further leads to the ballooning of bronchi and difficulty in clearing secretions with recurrent infection of the respiratory tract. Pulmonary hypertension is another major complication after bronchiectasis which affects pulmonary circulation. A 44-year-old female reported to the physiotherapy department with cystic bronchiectasis and pulmonary hypertension. The positive symptoms were chronic cough with mucoid sputum, low-grade fever, chest pain, breathlessness (modified Medical Research Council (mMRC) grade III), and easy fatiguability. The goals were set and inpatient Pulmonary Rehabilitation (PR) started with the aim of reducing burdening of symptoms and promoting the Quality of Life (QoL). The therapeutic interventions were splinted coughing techniques, deep breathing exercises, thoracic expansions, postural correction exercises, dyspnoea relieving positions, strength training, and pacing techniques. After rehabilitation the ventilation along with strength improved, dyspnoea was reduced, and exercise tolerance was increased.