How a Physiotherapist can Help with Pneumonia

  •   February 6, 2018
  •  Nancy Littke, PT, Practice Advisor

Pneumonia is an infection in your lungs that causes the air sacs in one or both of your lungs to fill with fluid or pus. This can result in some or all the following symptoms:1

  • Feeling unwell
  • Having a very bad cough that may or may not cause you to cough up phlegm (or pus)
  • Developing a fever and/or chills
  • Feeling like you cannot get enough breath (shortness of breath)
  • Feeling very tired and weak

For normally active and healthy people, pneumonia may make you feel quite ill for two to three weeks. With rest, fluids, and medications (if prescribed by a doctor) most people recover quickly and can return to their normal activities.2

For the elderly, the very young, or people who already have a weakened immune system or other health problems, pneumonia can quickly become very serious and lead to hospitalization, increased frailty, or even death.1

In the acute phase of pneumonia, medical treatment recommendations include:2

  • Getting plenty of rest and sleep
  • Drinking lots of water
  • Staying away from others who are sick or who may be at a greater risk to catch the infection
  • Taking antibiotics if the doctor has identified a bacterial infection as the cause

The problem with bedrest

When you are feeling very ill, you may be tempted to take the recommendation to “get plenty of rest” to the extreme and to stay in bed for an extended period of time. This may occur regardless of whether you are at home or in the hospital. However, there are several reasons why it’s important that you continue to get up and move around, remaining as active as you are comfortably able to be.

Research indicates that 73%–83% of the measured hospital stay of older patients is spent lying in bed.3 Loss of function after a hospital stay has been shown to last up to one year following discharge, and not recovering to your pre-illness status has been associated with increased risk of institutionalization, prolonged disability, and death.4 Research suggests that care that supports independence and physical activity may decrease overall loss of function associated with hospitalization, leading to better long-term outcomes.4

The hospital environment can contribute to this inactivity by encouraging you to not get up on your own or placing you on bed rest. Hospital equipment such as bedrails, intravenous poles and urinary catheters also makes it harder for you to move around, especially if you are elderly or at greater risk for falling.

Family and friends may also enable inactivity, out of concern by continuing to encourage bedrest and by doing as much as they can for you. It is very important that family members encourage and assist you with as much early physical activity as possible, especially during hospitalization.

How a physiotherapist can help

To help combat the risks of pneumonia and ensure a faster, more complete recovery, you may have a physiotherapist come to see you while you are in hospital.

The physiotherapist will start by assessing your breathing and your present level of activity.

If you are having trouble breathing, you may be taught simple deep breathing exercises and resting positions that will make breathing easier. Deep breathing helps ensure air is moving throughout the entire lung so that there is less likelihood of the secretions pooling in the lower part of your lungs and the infection continuing. It can also help stimulate you to cough and clear the secretions already present.

The physiotherapist may provide you with any necessary aids, such as a walker, to get you up moving safely as early as possible. Even sitting at the side of the bed, transferring to a chair and walking to the bathroom assists in getting you moving. These simple activities will also help improve your lung function by encouraging you to taking deeper breaths and help with circulation making it easier for your heart to work. Once you are able, a walking program may be introduced to ensure you are getting up and more active every day.

You may have heard about friends or family members having chest physiotherapy when they were in hospital with a chest infection or other lung diseases. In the past, this form of therapy, which included “thumping” or “pounding” on the chest, was considered helpful in clearing secretions from your lungs. However, recent studies have concluded that there is limited evidence to support this therapy; therefore, this type of chest physiotherapy is no longer recommended as routine additional treatment for pneumonia in adults.5

Once you start to get over the acute stage, a physiotherapist can help you return to your previous activity levels. The therapist will help you develop an exercise program that gradually increases the strength in your legs, arms, and your breathing stamina to help you reach your goals. These programs can usually be done at home and a home care or clinic-based physiotherapist can see you at specific intervals to assess how you are progressing and add or change exercises as needed. The therapist can then help guide you back to your normal routines. It may take quite a long time for you to feel fully recovered and back to normal following a significant illness.             

Patience and persistence is the key. As you continue to increase your activity levels and your overall endurance, your shortness of breath will decrease, your strength will return and you will have more energy. As your general health improves, even with a chronic lung condition, so does your body’s ability to fight off infections and avoid future bouts of pneumonia. You should be able to get back to your previous daily routines, work, and leisure activities.

To find a physiotherapist near you who can help you recover from a serious illness click here.

  1. Mayo Clinic – Pneumonia Accessed: Dec.13, 2017
  2. Pneumonia Accessed Dec 18, 2017
  3. Callen B L, Mahoney J, Grieves C B, Wells T J, Enloe M. Frequency of hallway ambulation by hospitalized older adults on medical units of an academic hospital. Geriatr Nurs 2004; Volume 25(4), 212 - 217 Accessed Jan 10, 2018
  4. Boyd C M, Landefeld C S, Counsell S R, Palmer R M, Fortinsky R H, Kresevic D, et al. Recovery of Activities of Daily Living in Older Adults After Hospitalization for Acute Medical Illness. J Am Geriatr Soc 2171–2179. doi:10.1111/j.1532-5415.2008.02023. Accessed Jan 10, 2018
  5. Yang M, Yan Y, Yin X, Wang BY, Wu T, Liu GJ, et al. Chest physiotherapy for pneumonia in adults. Cochrane Database of Syst Rev. 2013; Issue 2. Art. No.: CD006338. DOI: 10.1002/14651858.CD006338.pub3 Accessed Jan 10, 2018