Impact of physiotherapy programme on quality of life and functional independence post anterior mediastinal tumour with myasthenia gravis

Chaitanya A. Kulkarni, Om C. Wadhokar, Waqar M. Naqvi*

Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Wardha, Maharashtra, India.

ABSTRACT

A thymoma occurs in approximately 15 per cent of adult diagnosed with Myasthenia gravis (MG). Recent studies have supported the active role of structured physiotherapy rehabilitation program post MG and its complicating symptoms. A male patient, 61 years old, was admitted to the physiotherapy out-patient department with present complains of lump in neck region with generalised weakness and early fatigability. From past two months, the patient faced difficulty in both basic and instrumental activities of daily living such as swallowing, transportation and regular hand movements. Investigation for the patient was carried out in which chest X-ray, CT chest and serum Ach R (positive) was done and was diagnosed with thymoma. Restricted muscle examination of the shoulder and scapular muscle was positive showing symptoms of chest pain and was rated 3/5 with associated discomfort giving away fatigue. The patient was operated for thymectomy which was an elective surgical procedure, operated under general anaesthesia for a duration of approximately 4 hrs. The patient was then referred for post-operative physiotherapy rehabilitation with incisional pain, cough with expectoration, early fatigue and reduced upper limb strength. The patient had a history of Type II Diabetes Mellitus. The focus of the physiotherapy rehabilitation program included airway clearance techniques, monitored graded bed mobilization, aerobic training and progressive resistance training. There was a significant improvement in the patient after 6 weeks of physiotherapy rehabilitation program. The early excision of thymoma with prompt tailor made supervised exercise program helps in early recovery and achievement of functional goal thus improving the quality of life and functional independence.

Keywords:

Myasthenia gravis; Thymoma; Thymectomy; Physiotherapy Rehabilitation