The right lower extremity was placed in a cylinder cast. About eight hours after admission, the patient was extubated. Following extubation, a left lower-lobe atelectasis developed with diminished breath sounds over the left base. At that time, chest physical therapy was initiated. Treatment consisted of turning the patient on her right side, one-third turn from prone, in the Trendelenburg position for bronchial drainage with vigorous percussion and vibration. The patient was not cooperative and had a weak cough because of abdominal pain. Therefore, the chest physical therapist had to