Background: Traumatic brain injury (TBI) is one of the main reasons of death & life-long disability worldwide. The rehabilitation programs designed for the TBI patients vary globally & thus, there is no standardized TBI specific rehabilitation program. TBI is still an enduring issue in the hospital’s ICU globally. The approaches used by the Physical therapists in ICU worldwide are; a) Positioning b) manual hyper inflammation technique (MHT), mobilization, Postural drainage (percussion, vibration and cough) & breathing exercise. Case report: This study was performed in the ICU of Swat Institute of Medical Science & Research center (SIMS). The patient’s chief complaint was gunshot injury to the left temporal injury& diagnosed with the left frontal partial contusion associated with the left temporal bone fracture, midline shift & subarachnoid edema. The physical therapy interventions given to the patient were; chest physiotherapy with zero-pressure manual hyperinflation & percussions initially. Later on, 30cm-pressure manual hyperinflation, modified postural drainage & minimal –handling saline suctioning were applied when the patient’s ICP (intracranial pressure) were controlled. Post-extubation of the TBI patient chest physiotherapy consisting of active cycle of breathing (ACBTs), motor re-learning program, volume-oriented incentive spirometry & mobilization. The outcome measurement used for the patient was modified rancho loss amigos level of cognitive functioning scale, secretion status & arterial blood gas analysis. Results: the TBI patient secretions status improved significantly from P1 to M1. FiO2 was improved from 39% to 20%, chest wall volume was increased from 225cc/sec to 600cc/sec &similarly, RLA level was increased from level 1 to level 8. Conclusion: this case report results showed that chest Physiotherapeutic interventions in the ICU for the TBI patient can significantly improve the patient’s cardiopulmonary status & prevent potential pulmonary complications.the result of this case report also shows that early mobilization of the TBI patient in the ICU results in the improvement of patient’s cognitive & behaviors functions. The study demonstrated that the early mobilization of the TBI patient in ICU is a good predictor of the treatment –cost.

Traumatic brain injury, chest physiotherapy, mobilization, motor relearning program