Do Chest Expansion Exercises Aid Re-shaping the Diaphragm Within the First 72Hours Following Lung Transplantation in a Usual Interstitial Pneumonia Patient?

Background and Purpose: Usual interstitial pneumonia is a chronic pulmonary disease, and it is characterized by progressive and rapid lung fibrosis and typically affects patients older than 50years. This study sought to discuss the use of chest expansion exercises during the immediate post-operative phase in a lung transplantation recipient. Methods: This was a non-experimental case report study. A 58-year-old man who was affected by usual interstitial pneumonia with severe respiratory insufficiency requiring continuous oxygen therapy underwent double lung transplantation. Pre-operative x-ray showed elevation of the diaphragm. Rehabilitation treatment started within the first 24h. Pain intensity was assessed using a numeric rating scale, and pulmonary function was evaluated based on variation in tidal volume. Each treatment lasted about 1h, and the sessions were initially carried out twice daily, increasing over the intensive care unit stay to three or four times daily. Results: At 72h, the tidal volume increased to 850-900mL (approximately 400mL more than baseline) during the chest expansion exercises. The diaphragm began to gradually lower. Chest x-ray examination on post-operative day 6 showed further reshaping of the diaphragm. Conclusion: Chest expansion exercises seem to be suitable in order to re-establish lung volume and diaphragmatic function as early as within the first 72h after bilateral lung transplantation.