Amy J. Litterini
© 2018 Bayley Archinal
Background and Purpose: Bronchiectasis is a disease defined by abnormal dilation of the bronchi from recurrent infections and/or chronic inflammation, which can lead to irreversible lung damage. Based upon severity and patient response to conservative treatment, a lobectomy may be required to resolve their symptoms. Though surgery may provide symptom relief and improve overall quality of life, patients are likely to have long-term pulmonary complications. There are several studies regarding the treatment of patients with pulmonary limitations secondary to a lobectomy. However, there is little to no evidence regarding the long-term treatment of patients who have undergone multiple lobectomies. The purpose of this case report was to describe an appropriate intervention program for an 82-year-old female who suffered from multiple pulmonary complications secondary to multiple lobectomies. Case Description: The patient was an 82-year-old female who had multiple lobectomies at age 18 secondary to bronchiectasis. She was admitted to a skilled nursing facility (SNF) with a diagnosis of a chronic obstructive pulmonary disease (COPD) exacerbation. Her primary symptoms included generalized weakness and increased dyspnea. The prescribed intervention program included cardiovascular endurance training, dynamic standing balance activities and bilateral lower extremity (BLE) strengthening. Outcomes: The distance on the 6-Minute Walk Test (6MWT) increased by 36.0 meters (m) (140.8m to 176.8m), dynamic standing balance increased from fair+ to good, BLE strength increased from 3+/5 to 4/5 (fair to good) and ambulation distance improved from 150 ft using a two-wheeled walker (2WW) to 300 ft using a four-wheeled walker (4WW). Discussion: Incorporating cardiovascular endurance training, dynamic standing balance exercises and BLE strength training appeared to have improved this 82-year-old woman’s independence with functional mobility at discharge.
Archinal, Bayley, "Inpatient Physical Therapy Management For A Patient With Chronic Pulmonary Complications Secondary To Multiple Lobectomies: A Case Report" (2018). Case Report Papers. 92.