Case Study – Pulmonary Rehabilitation

June 2, 2017 | By | Reply READ MORE...

– Dr Niriksha Khasgiwala

A 75 year old lady came to PhysioRehab with complaints of severe cough and pain in the ribs since the past 5 years. She has a history of Bronchiectasis (lung condition in which the air tubes in the lung get damaged permanently and hence cause collection of secretions which eventually leads to infections).
She was advised chest physiotherapy (pulmonary rehab) by her doctor and was told that physiotherapy is the only treatment that is going to keep her comfortable.
She is also highly osteoporotic. Two years back she suffered a fall, after which she also had lower back pain.

LIFESTYLE:

  • Working for 6-7 hours a day which involved interacting with people
  • Cooking
  • Taking lectures and seminar
  • Uses public transport to commute

SYMPTOMS:

  • Cough (certain positions like lying down flat aggravates it further)
  • Cough worse in the morning
  • Severe phlegm
  • Right side lower rib pain
  • Breathlessness
  • Fatigue due to excessive coughing
  • Occasionally blood stained sputum

INVESTIGATIONS:

  • Chest X-ray
  • Pulmonary Function Test (PFT)

TREATMENT:

We at PhysioRehab charted out a plan for her where the focus was pulmonary rehab but also helped her simultaneously with her rib and low back pain. Cardiovascular conditioning is also gradually been worked upon.

Chest Physiotherapy –

  • Includes specific physiotherapy techniques to be done by therapist that helps to mobilise the secretions which makes it easier for the secretions to come out.
  • Utmost care is taken during the rehab by paying close attention to all the vitals like heart rate, oxygen saturation and blood pressure before and after the treatment.With severe osteoporosis we had to be very careful while performing any technique on her as with such patients bones become very brittle.
  • Auscultation before and after the treatment is a must.

Postural Drainage –

  • Placing the patient in specific positions so that it assists the movement and drainage of the secretions

Postural Training and General Conditioning –

  • Due to chronic pulmonary complaints there are lot of postural compensations and use of incorrect muscles during respiration.
  • Postural correction exercises.
  • Upper back strengthening.
  • General conditioning exercises.

Cardiovascular Conditioning –

  • Static bicycling with good back support.

Breathing Exercises –

  • Exercises to assist and improve chest expansion.
  • Exercises that help relax the overused muscles.
  • Graded breathing techniques to overcome breathlessness.

Relaxation and relieving positions during severe cough attacks were taught in order to keep her more comfortable during such times.
Post session she always feels much lighter in her chest as she immediately starts coughing her secretions out which keeps her lung congestion free for most part of the day.

Her quality of life has improved drastically. Also regular rehab in a totally sterile manner has kept her away from repeated antibiotic intake and hospitalisation.Hence prevented from having other added side effects.

PhysioRehab has worked with variety of pulmonary patients and have strived to get the best results and made a difference in their lives.
We at PhysioRehab understand and empathise with our patients with pulmonary conditions and constant issues that they face in daily activities. We try and make them as comfortable as we can by charting out a Pulmonary Rehab plan suiting their individual needs.

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Category: Case Studies

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