Cardiorespiratory physiotherapy is one of the most foundational — yet often under-recognised — specialties in the profession. From intensive care units to pulmonary rehab classes, these clinicians are experts in helping people breathe, move, and recover. In a world reshaped by long COVID, chronic disease, and aging populations, the role of cardiorespiratory physios has never been more vital.

At its core, cardiorespiratory physio helps manage conditions affecting the heart, lungs, and vascular system. This includes chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, cystic fibrosis, pneumonia, cardiac failure, post-operative complications, and more. Therapists also play a critical role in ICU and surgical recovery, cancer care, and prehabilitation.

“You’re not just treating a diagnosis,” says physiotherapist Emily Kline, who works in acute respiratory care at Royal Brisbane and Women’s Hospital. “You’re supporting a person’s breath, energy, and dignity — and often doing it in their most vulnerable moments.”

In hospital settings, cardiorespiratory physios are often part of critical care teams. They help clear secretions, optimise lung function, prevent secondary complications like atelectasis or pneumonia, and support early mobilisation. Interventions might include manual techniques (percussion, vibrations), airway suctioning, breathing retraining, positioning, and exercise prescription.

Post-operatively, especially after cardiothoracic or abdominal surgery, early physiotherapy can reduce complications and shorten length of stay. Mobilisation and respiratory training begin as early as day one. According to the Australian Physiotherapy Association, cardiorespiratory physios are crucial to post-op recovery pathways — and evidence shows they reduce readmission and improve long-term outcomes.

Cardiorespiratory physios are also key players in chronic disease management. Pulmonary rehab, delivered in community and outpatient settings, supports patients with COPD, bronchiectasis, and interstitial lung disease to build endurance, reduce dyspnoea, and improve quality of life. Programs usually combine aerobic and resistance exercise, education, self-management coaching, and breathing strategies such as pursed-lip breathing or paced breathing.

Take Paul, 72, who joined his local pulmonary rehab program after being hospitalised with COPD exacerbation. “I was scared I’d never get my independence back,” he says. “But physio gave me the tools and the confidence. I can now walk to the shops without sitting down five times.”

Cardiac rehabilitation is another key area. After events like myocardial infarction, valve surgery, or stenting, patients benefit from progressive exercise training, education, and psychological support. Cardiorespiratory physios tailor rehab to the individual’s goals, comorbidities, and medications — often coordinating with nurses, exercise physiologists, and cardiologists.

“The first time a patient walks into a rehab class post-heart attack, they’re often anxious,” explains physio Josh Arnold from a regional Queensland health service. “Our job is to make movement safe again — physically and emotionally.”

With the rise in long COVID and post-viral fatigue syndromes, physios are now at the forefront of helping patients manage breathlessness, energy conservation, and graded return to activity. The APA’s cardiorespiratory group has developed guidance on pacing strategies, symptom monitoring, and when to refer on.

Technology is also expanding what’s possible. Remote monitoring, tele-rehab platforms, and portable spirometry allow patients in rural and remote areas to access specialist support. The COVID-19 pandemic accelerated digital health innovation, and many clinics have maintained hybrid models to reach patients who may otherwise miss out.

Prehabilitation is another growing niche. Patients undergoing major surgeries — especially for cancer or cardiovascular disease — often benefit from physiotherapy in the weeks leading up to their procedure. This might involve respiratory training, walking programs, education, and strengthening exercises to improve post-op resilience. Evidence from Australia and abroad suggests prehab can reduce ICU time, complications, and hospital length of stay.

Communication is central to cardiorespiratory physio. Many patients are anxious or frightened — particularly when facing breathlessness or complex terminology. Physiotherapists must explain interventions clearly, support behaviour change, and work collaboratively with families and carers. In some settings, they may also help coordinate discharge planning or equipment access, such as mobility aids or oxygen therapy.

Despite the challenges, clinicians describe the work as uniquely rewarding. “When someone walks out of ICU, or tells you they vacuumed their house for the first time in months — those are wins,” says Emily Kline. “You don’t forget those moments.”

Cardiorespiratory physio isn’t always fast-paced, but it is deeply dynamic. Therapists might begin their day in a high-dependency unit and end it coaching someone through stairs in a community centre. Every setting has different rhythms, but all require sharp clinical reasoning, responsive decision-making, and excellent communication.

A growing number of physios are also working in oncology rehabilitation, supporting patients with breathing and exercise capacity before, during and after treatment. Others support people with neuromuscular conditions, chronic fatigue, or obesity where breathlessness and energy limitation reduce participation. The breath is a powerful starting point for functional change.

Training in cardiorespiratory physio starts at the undergraduate level but typically involves postgraduate coursework, clinical rotations, and ongoing CPD. The APA and The Cardiorespiratory Special Group offer resources, mentoring and national events. Specialist roles are available in ICU, CF clinics, oncology, and community rehab.

For new grads, it’s a steep learning curve. Acute settings can be intense — but the clinical reasoning, multidisciplinary collaboration, and holistic care skills are career-defining. Many physiotherapists find that their time in respiratory rotations becomes a cornerstone of their professional identity.

Cardiorespiratory physio might not get the same spotlight as sports or ortho, but it’s the engine room of functional recovery. It restores breath. It restores capacity. And for thousands of Australians every day, it restores life’s rhythm — one breath at a time.

As healthcare continues to evolve, so too will the role of cardiorespiratory physiotherapists. Their ability to adapt — whether to new technologies, shifting patient needs, or global health challenges — will remain essential in the years ahead.

More than a clinical skillset, cardiorespiratory physiotherapy is a long-term partnership with patients navigating chronic illness, recovery, or breathlessness. With every session, physios help shape not only physical outcomes, but confidence, independence, and a renewed sense of possibility.