Neurophysiological Facilitation of Respiration (NPF): Difference between revisions
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===== '''Observation''' ===== | ===== '''Observation''' ===== | ||
* Increased epigastric excursions | * Increased epigastric excursions | ||
* As the stimulus is maintained the epigastric excursions may increase so that movement is transmitted to the upper thorax and the patient appears to be deep breathing | * As the stimulus is maintained the epigastric excursions may increase so that movement is transmitted to the upper thorax and the patient appears to be deep breathing | ||
* Swallowing | * Swallowing | ||
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'''Method''' | '''Method''' | ||
Intercostal stretch is provided by applying pressure to the upper border of a rib in order to stretch the intercostal muscle in a downward(not inward) direction. The stretch position is then maintained while the patient continues to breathe in his/her usual manner. This procedure can be performed unilaterally or bilaterally on any rib with the exception of the floating ribs. Care must be taken to avoid sensitive mammary tissue in female patients. | |||
===== '''Observation''' ===== | ===== '''Observation''' ===== | ||
* Increased epigastric movements | |||
* Increased muscle contraction (rectus abdominous) | |||
* Decreased girth in obese | |||
* Increased firmness to palpation | |||
* Depression of umbilicus | |||
===== '''Mechanism''' ===== | ===== '''Mechanism''' ===== | ||
Intercostal stretch reflex | |||
==== '''Thoracic vertebral pressure''' ==== | ==== '''Thoracic vertebral pressure''' ==== | ||
'''Method''' | '''Method''' | ||
vertebral pressure high - manual pressure applied to thoracic vertebrae in the region T2 - T5 | |||
vertebral pressure low - manual pressure applied to thoracic vertebrae in the region T9 - T1 | |||
===== '''Observation''' ===== | ===== '''Observation''' ===== | ||
vertebral pressure high | |||
* Increased epigastric excursions | |||
* Deep-breathing | |||
vertebral pressure low | |||
* Increased respiratory movements of apical thorax | |||
===== '''Mechanism''' ===== | ===== '''Mechanism''' ===== | ||
Revision as of 14:50, 8 May 2020
Neurophysiological Facilitation of Respiration (NPF)[edit | edit source]
Neurophysiological Facilitation of Respiration is a treatment technique used for respiratory care of patients with unconscious or non-alert, and ventilated, and also with a neurological condition
NPF is the use of external proprioceptive and tactile stimuli that produce reflex respiratory movement responses and that increase the rate and depth of breathing
Indication[edit | edit source]
Contraindication[edit | edit source]
Techniques[edit | edit source]
There are six techniques used in the NPF
- Perioral pressure
- Intercoastal stretch
- Thoracic vertebral pressure
- Co-contraction of the abdominal muscles
- Applied manual pressure
- Anterior stretch-lifting of the posterior basal area (Basal Lift)
Perioral pressure[edit | edit source]
Method[edit | edit source]
The pressure is applied to the patient's top lip by the therapist's finger and maintained. The pressure is maintained for the length of time that the therapist wishes the patient to breathe in the activated pattern. (As a precautionary measure the use of surgical gloves is advised to avoid picking up a contaminant and/or carrying contaminants from one patient to another).
Observation[edit | edit source]
- Increased epigastric excursions
- As the stimulus is maintained the epigastric excursions may increase so that movement is transmitted to the upper thorax and the patient appears to be deep breathing
- Swallowing
- Mouth closure
Mechanism[edit | edit source]
The primitive reflex response related to sucking
Intercoastal stretch[edit | edit source]
Method
Intercostal stretch is provided by applying pressure to the upper border of a rib in order to stretch the intercostal muscle in a downward(not inward) direction. The stretch position is then maintained while the patient continues to breathe in his/her usual manner. This procedure can be performed unilaterally or bilaterally on any rib with the exception of the floating ribs. Care must be taken to avoid sensitive mammary tissue in female patients.
Observation[edit | edit source]
- Increased epigastric movements
- Increased muscle contraction (rectus abdominous)
- Decreased girth in obese
- Increased firmness to palpation
- Depression of umbilicus
Mechanism[edit | edit source]
Intercostal stretch reflex
Thoracic vertebral pressure[edit | edit source]
Method
vertebral pressure high - manual pressure applied to thoracic vertebrae in the region T2 - T5
vertebral pressure low - manual pressure applied to thoracic vertebrae in the region T9 - T1
Observation[edit | edit source]
vertebral pressure high
- Increased epigastric excursions
- Deep-breathing
vertebral pressure low
- Increased respiratory movements of apical thorax
Mechanism[edit | edit source]
Co-contraction of the abdominal muscles[edit | edit source]
Method
Observation[edit | edit source]
Mechanism[edit | edit source]
Applied manual pressure[edit | edit source]
Method
Observation[edit | edit source]
Mechanism[edit | edit source]
Anterior stretch-lifting of the posterior basal area (Basal Lift)[edit | edit source]
Method
