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How these guides are written and reviewed →
Your first appointment is where your physiotherapist gets to know you and your breathing or heart health, so they can build a plan that suits you. You will talk through your medical history and what has brought you in, have some simple measurements taken (such as your pulse, breathing, blood pressure and oxygen level) and have your chest listened to. You may do a short walking or exercise test to measure your starting point, and your physiotherapist will review any scans or previous test results and may suggest further investigations. This page explains what to expect and how to prepare.
What to expect at your first assessment
Your first appointment usually lasts around 45 minutes. It is a relaxed conversation and examination — nothing invasive — and there is time to ask questions. It generally includes the following.1
Your history and presenting condition
Your physiotherapist will ask about the problem that has brought you in and about your prior medical history — your symptoms and how they have changed, breathlessness and exercise tolerance, cough and sputum, past and current health conditions, smoking history, any workplace or environmental exposures, and your goals. They will also go through your current medicines and check your inhaler or nebuliser technique.2
Objective assessment
A set of simple measurements gives an objective picture of how your heart and lungs are working and a baseline to track over time. This usually includes:3
- Heart rate (HR) — your pulse.
- Respiratory rate (RR) — how fast you are breathing.
- Blood pressure (BP).
- Oxygen saturation (SpO₂) — a soft clip on your finger.
- Auscultation — listening to your chest with a stethoscope, and watching your breathing pattern.
Exercise testing
Your assessment may include a simple exercise test — such as a walking test — to measure your exercise tolerance and see whether your oxygen level changes with activity. This gives a clear starting point to measure progress against. Wear comfortable clothing and shoes in case a walking test is done.4,5
Reviewing your scans and previous tests
Your physiotherapist will review any scans and previous test results you have had (for example spirometry, chest X-rays or CT scans, and blood tests) to build a complete picture and avoid repeating tests unnecessarily.
Recommendations and next steps
At the end, your physiotherapist will explain what they have found, agree a treatment plan tailored to you, and — where useful — make recommendations for further investigations or referral. You will leave knowing the next steps.
- A list of your current medications (including inhalers, puffers and nebulised medicines), and your devices if you use them.
- Copies of your previous test results and scan reports if you have them — spirometry, X-rays or CT, blood tests.
- Comfortable clothing and shoes, in case a walking or exercise test is done.
References & evidence base
- Bott J, Blumenthal S, Buxton M, et al. Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient. Thorax 2009;64(Suppl 1):i1–i52.
- Parshall MB, Schwartzstein RM, Adams L, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med 2012;185(4):435–452.
- Graham BL, Steenbruggen I, Miller MR, et al. Standardization of spirometry 2019 update: an official American Thoracic Society and European Respiratory Society technical statement. Am J Respir Crit Care Med 2019;200(8):e70–e88.
- Holland AE, Spruit MA, Troosters T, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 2014;44(6):1428–1446.
- Bohannon RW, Crouch R. Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: a systematic review. J Eval Clin Pract 2017;23(2):377–381.
References are numbered in citation order (Vancouver/BMJ style) and were current at the time of writing. Guidelines are living documents — verify against the latest version before clinical use.
Everything starts with an assessment — your symptoms, breathing, exercise tolerance and daily function measured properly, so what follows is built on your lungs rather than an average.
Corrections: If something on this page is wrong, out of date or unclear, we want to know. Email reception@inspireclinic.au with the page name and what you believe is incorrect. Substantive corrections are made promptly, and the guide’s version and last-updated date are changed to reflect it.