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Chest Physiotherapy: How Can It Help You Breathe More Easily ?

[fa icon="calendar"] Sep 15, 2020 10:00:00 AM / by Calvin Leong

 

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Chest physiotherapy is a treatment for people with diseases that affect the lungs or air passages, such as bronchiectasis or cystic fibrosis. This therapy helps a patient cough out extra mucus, also called secretions, from the lungs. Removing the mucus reduces the risk of lung infections and makes breathing more comfortable.

How Does Chest Physiotherapy Work?

Chest physiotherapy removes extra mucus from the lungs by moving the mucus into the upper airways. From there, the mucus can be coughed out. Various methods may be used to move the mucus into the upper airways, including physical techniques and the use of certain postures or positions.

When Is Chest Physiotherapy Done?

Your healthcare provider will determine when and how often you should do chest physiotherapy. The therapy is usually done:

  • in the morning. This helps to clear out mucus that collected during sleep hours.
  • before bed. This ensures a comfortable sleep during the night.
  • before a meal. This ensures that the stomach is empty to prevent vomiting.
  • 1½–2 hours after a meal. This helps to prevent vomiting.

Digital blue human with highlighted lungs on dark blue background

What Are Some Common Techniques?

Various techniques may be used in chest physical therapy. Many techniques require help from a physiotherapist or a trained family member or caregiver. Your healthcare provider will recommend the methods that will work best for you. Some common methods include:

Postural drainage

In this method, you are placed in certain positions where gravity helps to drain the mucus from the lungs into the bigger airways. This is where the mucus can be easily coughed out. This technique is often done with chest percussion.

Chest percussion and chest vibration

Chest percussion and chest vibration helps to break up thick mucus in the lungs so it can be more easily removed with coughing or huffing.

  • Chest percussion is also called cupping or clapping.
  • In the chest vibration technique, the therapist or caregiver uses his or her hands to produce vibrations on your chest.

Mechanical devices are also sometimes used for chest percussion and chest vibration. These include:

  • Electric chest clapper. This device may also be called a mechanical percussor.
  • Inflatable therapy vest. This device uses high-frequency airwaves to push mucus toward your airway, allowing you to cough it out.
  • Small, handheld devices that you breathe through. These devices create vibrations that can move (dislodge) mucus out of its place.
  • A mask that creates vibrations to dislodge mucus.

These procedures may be done along with postural drainage and percussion.

Controlled or assisted coughing

Controlled or assisted coughing techniques help to break down thick mucus and increase the cough pressure to expel the mucus. In some cases, an assisted coughing technique is used if a person is not able to produce a forceful cough. During this procedure, a therapist or caregiver will:

  • Place his or her hands just below your ribs while you are lying down or sitting.
  • Ask you to take one or two deep breaths.
  • Firmly push in and up toward your ribs as you cough.

Breathing techniques

Certain breathing techniques can help to expand the lungs and distribute air to all sections of the respiratory system. These can include:

  • Forced expiration technique. For this technique, you force out a few breaths, followed by regular, relaxed breathing.
  • Active cycle breathing. For this technique, you force out a few breaths, followed by deep breathing exercises.
  • Using an incentive spirometer. This involves breathing as deeply as possible through a tube that is attached to a small, plastic chamber. The plastic chamber has a ball inside, and each breath lifts the ball. This is typically done 5–10 times in a row each hour that you are awake.

 

female doctor examining a patient isolated over a white background

Contact your healthcare provider if you:

  • feel pain or discomfort after using any chest physical therapy techniques.
  • are not able to cough up any mucus, even after using chest physical therapy techniques.
  • have a fever.
  • have wheezing or a dry cough that does not produce mucus (unproductive).
  • are tired.

Get help right away if:

  • you have shortness of breath or cannot breathe.
  • you have severe pain after using any chest physical therapy techniques.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (999 in Malaysia) Do not drive yourself to the hospital.

Summary

  • Chest physical therapy removes extra mucus from the lungs by moving the mucus into the upper airways. From there, the mucus can be coughed out.
  • The therapy is usually done in the morning, before bed, before eating, or 1½–2 hours after eating.
  • Common methods of chest physical therapy include postural drainage, chest percussion, chest vibration, controlled or assisted coughing, and breathing techniques.

This information is not intended to replace advice given to you by your healthcare provider. Make sure you discuss any questions you have with your healthcare provider.

References:

Brooks D., Thomas J.: Interrater reliability of auscultation breath sounds among physical therapists. Phys Ther 2015; 75: pp. 1082-1088.

Horiuchi K, Jordan D, Cohen D, Kemper MC, Weissman C: Insights into the increased oxygen demand during chest physiotherapy. Crit Care Med 2017; 25: pp. 1347-1351.

Pattanshetty RB, Gaude GS: Effect of multimodality chest physiotherapy in prevention of ventilator-associated pneumonia: a randomized clinical trial. Indian J Crit Care Med 2010; 14: pp. 70-76.

 Stiller K: Physiotherapy in intensive care: towards an evidence-based practice. Chest 2018; 118: pp. 1801-1813.

 Heng H, Zhang Z, Gong Y, Chen M: [Effect of chest physiotherapy in patients undergoing mechanical ventilation: a prospective randomized controlled trial]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017; 29: pp. 403-406.

For more information on chest physiotherapy, visit:

Hospital Kuala Lumpur – Department of Physiotherapy

Malaysia Physiotherapy Association

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Topics: Wellness

Calvin Leong

Written by Calvin Leong

Calvin Leong holds a Master in Medical Education from the University of Dundee, United Kingdom. He is certified in Clinical Wound Care by the ASEAN Wound Care Association. Calvin has 20 years of clinical and lecturing experience focusing on Mentoring in Healthcare, Traumatology and Medical Sciences. Calvin is HRDC certified trainer. He is also a Life Member of The Malaysian Association for the Study of Pain (MASP) and the Malaysian Society of Wound Care Professionals (MSWCP).

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