Manajemen Fisioterapi Pada Pasien Post Torakotomi E.C Fraktur Costae Dengan Keluhan Sesak Napas Dan Kekakuan Otot Dada: Sebuah Laporan Kasus

Abstract

Rib fractures resulting from blunt chest trauma often lead to respiratory complications and long-term functional impairment when not properly managed (Pharaon, Marasco, & Mayberry, 2015; Seok et al., 2023). Thoracotomy performed to repair pleural injury after trauma can result in chronic pain, reduced chest wall expansion, and shoulder mobility limitation without prompt rehabilitation (Wildgaard, Ravn, & Kehlet, 2009). This case report aims to describe the physiotherapy management of a 57-year-old man presenting with mild dyspnea and chest muscle stiffness following post-traumatic thoracotomy. The patient underwent surgery on 8 December 2025 and presented to the Physiotherapy Outpatient Clinic of RSUD Bali Mandara on 28 July 2026, complaining of dyspnea during long-distance walking and stair climbing. Physiotherapy interventions included infrared, ultrasound, pursed-lip breathing, thoracic expansion exercise, and pectoralis stretching exercise over six sessions (28 July–3 August 2026). Outcomes were evaluated using the Visual Analogue Scale (VAS), midline chest expansion measurement, goniometry, manual muscle testing, the Borg scale, and the 2-Minute Step Test (2MST). Results showed a decrease in movement pain from 3/10 to 1/10 and pressure pain from 3/10 to 2/10, while dyspnea scores and shoulder muscle strength remained stable within normal limits. In conclusion, a combination of electrotherapy modalities and breathing–stretching exercises may help reduce pain in post-thoracotomy cases, although improvement in thoracic expansion and activity tolerance requires a longer treatment duration.