Why is vigorous chest physiotherapy not recommended for patients with advanced pulmonary tuberculosis?

Vigorous chest physiotherapy is not recommended for patients with advanced pulmonary tuberculosis primarily because it may cause expectoration of lung tissue. In advanced stages of pulmonary tuberculosis, the lung tissue can become severely damaged and necrotic due to the infection. When vigorous techniques are applied, there is a risk that this damaged tissue could become dislodged and expectorated, potentially leading to further complications, including the risk of bleeding or exacerbation of the patient's condition.

This concern is particularly relevant in advanced cases where the integrity of lung tissue is already compromised. Practices that may exert significant pressure or force can disturb existing lesions, potentially worsening a patient's health. Therefore, caution is paramount when considering the use of chest physiotherapy in these cases, as the risks often outweigh the potential benefits when it comes to managing advanced pulmonary tuberculosis.