Chest physiotherapy can be used for the treatment and prevention of chronic obstructive pulmonary disease (COPD), restrictive respiratory diseases including neuromuscular disorders and restrictive lung disease due to lung parenchyma abnormalities such as fibrosis and patients receiving mechanical ventilation. Chest physiotherapy includes a series: postural drainage, percussion, vibration, breathing exercises.
Chest PT is the treatments commonly done by the experienced respiratory therapists and physical therapists, whereby breathing is improved by the indirect removal of mucus from the breathing passages of a patient who is suffering from respiratory disorders.
During chest PT physiotherapists use several different techniques to help treat lung disorders, including, suctioning, postural drainage, and breathing exercises. The choice of treatment is based on the underlying disease and the person’s overall condition.
Chest physiotherapy composed of external mechanical maneuvers, such as:
- Chest percussion
- Postural drainage
- Mobilization and clearance of airway secretions
- Diaphragmatic breathing with pursed-lips
- Coughing and controlled coughing
When is chest physiotherapy required?
Generally Chest physiotherapy (CPT) required for patients whom cough is inadequate to clear thick, localized mucus secretions. For example: Bronchiectasis, Cystic fibrosis.
Chest physiotherapy required in several conditions such as:
- Cystic fibrosis
- If the respiratory muscles are weak
- Neonatal respiratory distress syndrome
- Mechanical ventilation
- Lung abscess
When chest physiotherapy not required?
Chest physiotherapy contraindicated when the patient is suffering from following conditions:
- Pulmonary embolism
- Acute spinal injury and recent spinal surgery
- Rib fractures
- Bronchopleural fistula
- Recent esophageal surgery
- Uncontrolled hypertension
- Uncontrolled airway at risk for aspiration
- Surgical wound or healing tissue, recent skin flaps on the thorax
- Osteoporosis, osteomyelitis of the ribs
- Suspected pulmonary tuberculosis
- Complaint of chest wall pain
Assessment for chest physiotherapy
- Assess the vital signs (pulse rate, respiration rate, blood pressure and temperature)
- Assess for contraindications
- Take complete physical examination of the chest
- Review the patient’s x-ray and other blood investigations
Techniques of chest physiotherapy
Chest physiotherapy consists of 4 techniques:
- Postural drainage
- Breathing exercises
How to do chest physiotherapy?
- Postural drainage: in postural drainage, the patient lies or sits in different positions so that part of the lung to be drained is as high as possible.
- Percussion: percussion is painless, rhythmic clapping with a cupped hand over an area of the chest. This is usually done for 3 to 5 min. The patient is then encouraged to cough or huff forcefully to get the mucus out of the lungs.
- Vibrations: sustained, downward, vibrating motion with the flat part of the palm. Vibration technique performs when the patient is exhaling. This technique helps in mobilize secretions and shakes the mucus so it can move into the larger airways.
- Breathing exercises: it consists four types of exercises pursed lips breathing, slow deep breathing, diaphragmatic breathing, and segmental breathing. The aims of breathing exercises are:
- Help the patients relieve and control breathlessness
- Prevent dynamic airway compression
- Improve ventilator pattern
- Improve gas exchange
How long does chest physiotherapy take?
Generally, each treatment session can last between 20 to 40 minutes. Chest physiotherapy is best done before meals or 11⁄2 to 2 hours after eating, to decrease the chance of vomiting. Early morning and bedtimes are usually recommended.
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Dr. Kaleem Mohammed graduated as a Bachelor of Physiotherapy in 2014 from Deccan College of Physiotherapy, affiliated to Dr. N.T.R. University of Health Sciences, Vijayawada, India. Dr. Kaleem is an expert at handling physiotherapy needs of patients suffering from orthopedic and spinal conditions and post-surgery rehabilitation. Dr. Kaleem is associated with HealthClues since its inception where he facilitates diagnosis and advanced consultation with senior doctors. He is also a medical researcher and prolific writer who loves sharing insightful commentaries and useful tips to educate the patient community about fitness, treatment options, and post-treatment recovery.