A case of herpes zoster-related phrenic nerve palsy: Effect of home-based pulmonary rehabilitation

Abstract

Here, we report the case of a 62-year-old man with herpes zoster-related phrenic nerve palsy, which was evident in clinical, radiological, and electrodiagnostic studies. To aid clinical recovery and preserve pulmonary function, we designed a home-based pulmonary rehabilitation program consisting of air-stacking exercises using ambu-bagging, respiratory muscle training to improve the strength and endurance of inspiratory and expiratory muscles, and aerobic and resistance exercises of the upper and lower limbs to improve and prevent the decline of cardiorespiratory fitness. The patient was monitored, and the exercises were adjusted through regular outpatient follow-up. During the overall follow-up period of 26 months, pulmonary rehabilitation led to an increase in forced vital capacity from 2,020 to 3,160 mL, and improved the diaphragmatic height index from -4.46 to 0.28. Clinical symptoms also showed notable improvement, as the Borg Rating of Perceived Exertion scale score decreased from 17 to 7. We found that a home-based, self-performed pulmonary rehabilitation program could promote recovery from herpes zoster-related phrenic nerve palsy. Not only is this important for the rapid restoration of respiratory function and symptomatic relief, it can also protect patients from respiratory complications.