Rehabilitation after pleurisy

Diagnosis of pleurisy - implies an inflammatory process of the pleural cavity with the formation of fibrous changes on the walls of the pleura or the accumulation of a certain amount of liquid content in the form of an effusion. It can be the result of purulent or serous inflammation of the lungs, mediastinum, accumulation of blood as a result of lung injury, against the background of neoplasms in the chest area or in any other organ, as a result of a general intoxication syndrome in the process of tumor decay.

If we talk about the benign outcome of one or another manifestation of pleurisy, then in the final stage of recovery, an adhesive process begins to develop between the pleura sheets, which leads to the adhesion of the pleural sheets to each other. This, in turn, causes a number of complications. To avoid these violations, it is necessary to take measures to prevent them as early as possible.

Prevention of pleurisy

Pleurisy is always a consequence of another disease, therefore, for its prevention, it is necessary to conduct the entire complex of examinations for its early detection:

• Radiography of the lungs.
• Computed tomography of the lungs.
• In the event of an injury or a not entirely clear process, a diagnostic, and subsequently a therapeutic pleural puncture, is performed.

This allows you to identify the development of the process at an early stage and makes it possible to conduct adequate therapy, which reduces the risk of developing an adhesive process in the pleural cavity.

The rehabilitation period after pleurisy

Rehabilitative or restorative measures begin immediately after the diagnosis of pleurisy is established, that is, even against the background of treatment of the underlying cause of the disease. The fact is that the lungs are cone-shaped and expand from top to bottom, from top to bottom. Moreover, they are more expanded from the back than from the front of the chest. In ordinary life, a person during breathing fills the upper part of the lungs more than the lower one, therefore, the load on the pleura is insignificant. Therefore, when it comes to the prevention of adhesions, it is necessary to create conditions for the expansion and complete filling of the lower parts of the lung with air. But with a normal inhalation, the muscles of the chest remain passive, it simply stretches, and if you create conditions when you artificially compress the chest during inhalation, then it will be difficult for the incoming air to stretch the muscles and they will begin to tighten and pull the pleura along with them. This is the basis of therapeutic breathing exercises, which are necessary to completely fill the lungs with air.

Types of breathing exercises

All breathing exercises use:

• exercises with a delay in inhalation or exhalation;
• slow and drawn out inhalations and exhalations;
• inhalation and exhalation exercises.

Varieties of breathing exercises

Strelnikova's paradoxical gymnastics - inhalation is quick, instant, like an injection, and exhalation is imperceptible spontaneous. To make it clearer, we can draw an analogy:

• sniff the air like a dog looking for a trace: sharply, noisily, quickly. Inhale short and frequent. Accompanied by voluntary movements with a turn of the head, arms or torso;
• exhale through the mouth, not through the nose and do not fix attention on it;
• try breathing to repeat the movements of the pump when a bicycle tire is inflated;
• take a series of several short breaths in a row until the lungs are completely stretched, but so that it is easy, without tension, and then exhale through the mouth.

You need to start training with the ability to do 2 - 4 - 8 - 16 - 32 breaths in a row and then exhale. But be sure to follow the rule so that it is easy to do. Therefore, begin to increase the number of breaths only when the initial number of them is easily given. To each his own, do not rush for numbers.

Breathing exercises according to Buteyko - hold your breath and do not take deep breaths. Breathing occurs imperceptibly to others, quietly. Start with an inhalation length of up to 2 seconds, this amount of air is exhaled in 4 seconds, and then hold your breath and do not breathe for 4 seconds. Gradually add 1-2 seconds for each movement. Stick to the rules so that your well-being does not change dramatically.

Abdominal breathing or diaphragmatic, when the diaphragm is stretched and lowered down. This breath is used in yoga practice:

• put your palms on your chest and stomach, inhale so that the palm on your stomach rises, but not on your chest,
• inhale a figuratively represented rose or other pleasant smell, stretch the inhalation as long as possible and exhale smoothly so as not to feel dizzy,
• after a normal breath, try to "blow out the candle" or "blow everything off the dandelion" in one go,
• make a calm breath and a sharp exhalation like karate "ha".

Breathing is accompanied by a variety of movements, and devices are used:

• after a normal breath, exhale the air into the water through the tube,
• when inhaling, spread your arms to the sides and, as you exhale, hug yourself as tightly as possible, do it quickly and sharply,
• while inhaling, raise your arms high above you and stretch, and then sharply lower your arms with an inclination down between your legs and exhale loudly,
• you can carry out exercises with a gymnastic stick, bend the body back, forward, turn right and left, tilt to the side.                                                                               

Rules for performing physical exercises:

• start exercises from the first day, after the permission of the attending physician;
• first with a minimum amplitude and gradually increase it;
• the number of repetitions also increases;
• perform a set of exercises 3-4 times a day;
• carry out exercises in different positions of the body - lying on the back, stomach, on the side of one and the other, sitting, standing, running in place or in motion;
• the intensity of performance is selected individually, but always to the point of fatigue, and not through force. Better less, but more often, increase as strength increases and overall well-being improves;
• if it is impossible to independently perform, resort to the help of an exercise therapy instructor or relatives (turn, lift).

Chest massage for pleurisy

Chest massage is allowed to be done only at the end of the acute phase of the disease. At the same time, the blood supply to the chest organs increases, the drainage function of the lungs improves, infiltrates in the pleural cavity dissolve more easily and quickly.

Massage is carried out in a comfortable position for the patient, and as the condition improves. It is advisable to carry it out in a different position - the anterior, posterior and lateral surfaces of the chest.

Massage can be classic using stroking, rubbing, kneading and patting.

During the massage, manual compression of the chest is applied in the area of ​​​​the middle ribs - the line of the nipples, from top to bottom and vice versa, from the sides. After the massage, it is recommended to immediately conduct a series of breathing exercises.

If the pleurisy was dry, then more rubbing movements are used, and if there is an exudative or wet cough, then patting is predominant.

Other types of massage:

• cupping massage in a fairly good condition of the patient,
• reflexogenic needle massage,
• gouache massage.

Physiotherapy for pleurisy

Types of physiotherapy treatment depend on the type and stage of pleurisy.

Preference is given to:

• UVI on the chest area,
• paraffin and mud applications on the back of the chest,
• electrophoresis with anti-inflammatory and absorbable drugs (iodine for dry pleurisy, and calcium for exudative pleurisy),
• in the late rehabilitation period, climatotherapy is prescribed in the sanatoriums of the Crimea, coniferous forest. Salt "caves" in local sanatoriums and dispensaries are analogues to them - a halochamber.