Early Physical Therapy Management of a Patient with Diaphragmatic Eventration Following Diaphragmatic Plication: A Case Report

Abstract

Diaphragmatic plication is the recommended surgical procedure for the treatment of diaphragmatic eventration in those who have failed conservative care. The present case report describes a 63-year-old male patient who presented with breathlessness on exertional activities. Chest X-ray and Computed Tomography (CT) of the thorax revealed diaphragmatic eventration on the right side. After failed conservative management, the patient underwent diaphragmatic plication surgery and was followed up with postoperative physical therapy management. Physical therapy intervention was started from 3 days postsurgery and was continued for 1 week. The treatment goals focused on reducing breathlessness, reducing pain on the incision site, preventing postoperative complications, and improving functional capacity. The present study highlights the benefits of early physical therapy interventions including incentive spirometer, dyspnea relieving techniques, Transcutaneous Electrical Nerve Stimulation (TENS), and light- to moderate-intensity aerobic exercises in the patient after plication surgery.

Keywords

diaphragmatic eventration - diaphragmatic plication - physical therapy - rehabilitation

Publication History

Article published online:
04 June 2024

• References

• 1 Cordeiro Jde A, Almeida AK, Oliveira Jr Sade. et al. Diaphragmatic eventration: review of current knowledge, diagnostic, and management options. Int J Med Res Health Sci 2016; 5 (03) 62-65
• 2 Kansal AP, Chopra V, Chahal AS, Grover CS, Singh H, Kansal S. Right-sided diaphragmatic eventration: a rare entity. Lung India 2009; 26 (02) 48-50
• 3 Gilbert A, Wei B. Diaphragmatic plication: current evidence and techniques in the management of the elevated hemidiaphragm. Video-assist Thorac Surg 2023; 8: 22
• 4 Beshay M, Abdel Bary M, Kösek V, Vordemvenne T, Mertzlufft F, Schulte Am Esch J. Minimally-invasive diaphragmatic plication in patients with unilateral diaphragmatic paralysis. J Clin Med 2023; 12 (16) 5301
• 5 Groth SS, Andrade RS. Diaphragm plication for eventration or paralysis: a review of the literature. Ann Thorac Surg 2010; 89 (06) S2146-S2150
• 6 Husch HH, Watte G, Zanon M. et al. Effects of transcutaneous electrical nerve stimulation on pain, pulmonary function, and respiratory muscle strength after posterolateral thoracotomy: a randomized controlled trial. Lung 2020; 198 (02) 345-353
• 7 Han KY, Bang HJ. Exercise therapy for a patient with persistent dyspnea after combined traumatic diaphragmatic rupture and phrenic nerve injury. PM R 2015; 7 (02) 214-217