Cardiopulmonary and Community Physiotherapy
This section tests respiratory assessment, exercise prescription in cardiac and pulmonary disease, and community-based rehabilitation that is safe, accessible, and sustainable.
Core rules and concepts
- Assess breathlessness, cough, sputum, chest expansion, breath sounds, oxygen saturation, and exercise tolerance.
- Breathing exercises include pursed-lip breathing, diaphragmatic breathing, and controlled breathing during activity.
- Pulmonary rehabilitation combines aerobic and resistance exercise, education, and self-management; it improves dyspnoea and quality of life.
- Cardiac rehabilitation has phases from inpatient mobilisation to outpatient and maintenance programmes.
- Community physiotherapy uses home programmes, group classes, and caregiver training; infection control and emergency planning are essential.
Worked example
A patient completes a 6-minute walk test with a distance of 350 m; predicted distance is 500 m, so achieved is 70%. The patient stops with Borg dyspnoea 7/10 and oxygen saturation falls from 96% to 88%. Reasoning: the test reveals exertional hypoxaemia and high symptom burden. Exercise should be prescribed with medical review, oxygen titration if indicated, interval walking, and monitoring. The result is interpreted alongside symptoms and saturation, not distance alone.
Traps that cost marks
- Assuming a normal resting oxygen saturation excludes exertional desaturation.
- Giving supplemental oxygen without prescription or target range.
- Missing contraindications to exercise such as unstable angina or uncontrolled arrhythmia.
- Prescribing community exercise without a home safety and adherence plan.