The efficacy of conventional chest physiotherapy in managing acute hypoxaemic respiratory failure

A man in his 60s presented with acute hypoxaemic respiratory failure secondary to post-COVID-19 fibrotic pneumonia, requiring 3 L/min oxygen therapy (peripheral oxygen saturation (SpO ₂ ) 75%), peripheral cyanosis, modified Borg Dyspnoea Scale score 4 and exertional desaturation. An 8-week physiotherapy protocol progressed from diaphragmatic breathing/gravity-assisted postures (days 1–3) through segmental percussion/proprioceptive neuromuscular facilitation (day 4 to week 2), short-lever/long-lever upper limb exercises (weeks 3–4), to trunk mobility/ambulation (weeks 5–8). Outcomes included oxygen weaning to 0.5 L/min, SpO ₂ 94% on room air, Borg score 1 and 50 m unsupported ambulation. The interventions enhanced secretion clearance, alveolar recruitment and ventilation–perfusion matching via titration matched to clinical stability (SpO ₂ ≥90% phase thresholds). This demonstrates the role of structured physiotherapy in resource-limited settings for post-COVID-19 recovery.