Physical therapy for the thoracic surgical patient

1
Physical therapy for the thoracic surgical patient
2
Treatment modalities

• Postural drainage
• Mechanical stimulation of the chest wall
• Huffing and coughing
• Suction
• Breath exercise and patient mobilization
• TENS (transcutaneous electrical nerve stimulation)

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Breath excercises and patient mobilization

• Relaxation exercise
• Localized breathing exercise
• Lateral basal expansion
• Diaphragmatic breathing exercises
• Upper lateral expansion
• Apical pectoral expansion

4
Modification in physical therapy techniques for
specific thoracic operations

• Empyema
• Localized breathing exercises should not be used
  for patients in the acute stage of empyma
• Pneumonectomy
• Localized and diaphragmatic breathing exercises
  should be performed mainly on the normal side.
• Postural drainage is contraindicated
  postoperatively if the pericardium has been
  opened.
• These patients should be taught to huff
• Arm movements should be encouraged and the
  patients should be ambulatory within 24 hours
  following the operation

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• Lobectomy
• Localized breathing exercises should be
  performed, particularly on the side of operation.
• When bronchiectasis is present, diaphragmatic
  breathing exercises, coughing, and postural
  drainage with percussion and vibration are
  especially valuable
• Percussion should not be used when hemoptysis is
  present
• Decortication
• Lung expansion should be encouraged by having the
  patient perform the localized breathing exercises
  that were practiced before surgery. And the
  exercise should be performed as soon as the
  patient is able to cooperate
• Percussion and vibration are contraindicated in
  the early postoperative period