Questions Flashcards
A patient presents with left upper extremity lymphatic post mastectomy. The PT plans to initiate lymphatic drainage exercise as part of the plan of care. Which of the following breathing exercises is the most appropriate for the therapist to teach the patient to perform prior to initiating lymphatic drainage exercises?
Diaphragmatic breathing
Lymphatic drainage exercises can help improve lymph flow by increasing lymph vessel contractions, increasing fluid uptake in the initial lymph vessels, improving the “muscle pump” to stimulate lymph flow, and increasing deep breathing which improves lymph flow in the thoracic duct. Basic guidelines for an exercise session include starting with trunk exercises followed by extremity exercises and working from the proximal joints to the distal joints. Compression bandages/ garments should be used when exercising.
Diaphragmatic breathing should be performed prior to lymphatic drainage exercises and the session should finish with additional trunk exercises and deep breathing to enhance lymphatic flow. Diaphragmatic breathing can assist in the movement of lymphatic fluid as the diaphragm descends during inspiration to increase the thoracic cavity volume and then the abdominals contract to assist with a controlled expiration. Changes in intra-abdominal and intra-thoracic pressures help creating a continual, gentle pumping actin that moves fluid in the lymphatic vessels. Diaphragmatic breathing is an important component throughout the exercises regimen for the management of lymphedema.
