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Physical Therapy Following Phrenic Nerve Graft Surgery: Implications Far Beyond Breathing

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Rehabilitative Surgery

Abstract

Rehabilitation of the diaphragm following a phrenic nerve graft involves a detailed pre-/postsurgical multisystem evaluation by a physical therapist to determine the extent of the long-standing unilateral or bilateral phrenic nerve paralysis. Primary (i.e., respiratory, endurance) and secondary (i.e., posture, pain) impairments are described. A bilateral paralysis has a devastating impact on the patient’s survival, often requiring mechanical ventilation, but unilateral paralysis is also devastating due to compensatory postural control strategies which can lead to balance impairments, gait deviations, sleep disruptions, musculoskeletal restrictions/pain, incontinence, and an ongoing risk of respiratory complications. If the consequences of phrenic nerve paralysis are not fully understood, assessed, and treated, the patient’s long-term quality of life outcomes may be impaired. Research with spinal cord injury gives physical therapists guidance for the development of an appropriate treatment approach to this population, but research specific to this novel area of phrenic nerve restoration is needed.

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Author information

Authors and Affiliations

  1. Massery Physical Therapy, 3820 Timbers Edge Lane, Glenview, IL, 60025, USA

    Mary Massery PT, DPT, DSc

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  1. Mary Massery PT, DPT, DSc
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Correspondence to Mary Massery PT, DPT, DSc .

Editor information

Editors and Affiliations

  1. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Andrew I. Elkwood

  2. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Matthew Kaufman

  3. Institute for Advanced Reconstruction, The Plastic Surgery Center, Shrewsbury, New Jersey, USA

    Lisa F. Schneider

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Massery, M. (2017). Physical Therapy Following Phrenic Nerve Graft Surgery: Implications Far Beyond Breathing. In: Elkwood, A., Kaufman, M., Schneider, L. (eds) Rehabilitative Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-41406-5_11

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  • DOI: https://doi.org/10.1007/978-3-319-41406-5_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-41404-1

  • Online ISBN: 978-3-319-41406-5

  • eBook Packages: MedicineMedicine (R0)

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