Early respiratory and functional rehabilitation after COVID-19-associated pneumonia in an older person: a case study with progressive exercises in sedestac

Functional recovery after COVID-19-associated pneumonia may be limited by dyspnea, muscle weakness, chest pain, deconditioning, and loss of autonomy, particularly in older adults after prolonged hospitalization. This study aimed to describe the application and clinical-functional course of a progressive respiratory and functional exercise system in a woman older than 65 years during the early post-discharge phase. A descriptive single-case design with 30-day follow-up was conducted using clinical-functional observation, analysis of ventilatory mechanics, and graded motor tasks performed in a seated position. The participant had controlled hypertension and hypercholesterolemia and, after approximately 21 days of hospitalization, presented chest pain, occasional cough, fatigue, perceived breathing difficulty, and reduced muscle strength. The intervention comprised four progressive upper-limb tasks intended to promote scapulothoracic mobility, thoracic expansion, postural control, and muscular activation related to ventilatory mechanics. At day 20, an observationally favorable course was documented in movement tolerance and perceived breathing capacity; by day 30, greater functional autonomy and no reported episodes of breathlessness during usual activities were recorded. These observations must be interpreted cautiously because they derive from a single case and were not supported by standardized physiological outcomes. Current evidence supports individualized pulmonary rehabilitation after COVID-19, while emphasizing the need to rule out exertional desaturation, cardiac impairment, and post-exertional symptom exacerbation before exercise training. For future replication, the protocol should include objective monitoring, validated functional tests, symptom scales, and explicit stopping criteria. The case contributes a feasible low-resource sequence for early functional progression while highlighting the methodological and safety requirements necessary for stronger clinical inference.