Respiratory Physiotherapy
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Description[edit | edit source]
Chest physiotherapy is a vital constituent of respiratory care. It is used as an important adjuvant treatment of most respiratory illnesses from chronic respiratory illnes ( COPDs Asthma, cystic fibrosis), neuromuscular diseases( muscular dystrophy, cerebral plays, Spinal cord injury, motor neuron diseases), and mechanically ventilated patients ( conscious or unconscious), and pre and post-surgeries.[1]
Chest physiotherapy is the term for a group of treatments designed to improve respiratory efficiency, promote the expansion of the lungs, strengthen respiratory muscles, and eliminate secretions from the respiratory system. These techniques are also used as preventive measures to prevent secondary complications such as pneumonia pre and post-surgery. Based upon the condition of the patient and goals to achieve, techniques of chest physiotherapy are chosen and applied. It is very necessary to keep in mind the contraindications and precautions of techniques of chest physiotherapy. For instance, rib fracture is absolutely contraindicated for percussions and vibrations, contagious viral infections causing pneumonia are relative contraindications for aerosol-generating techniques like huffing and coughing.
Classification[edit | edit source]
There are various physiotherapy treatment incorporated with chest physiotherapy. Chest physiotherapy techniques can be classified as conventional, modern, and instrumental techniques.
Conventional techniques[edit | edit source]
Conventional chest physiotherapy involves manual handling techniques to facilitate mucociliary clearance. It includes postural drainage, percussion, vibration, huffing, coughing, and thoracic squeezing. It can be self-administered or performed with the assistance of another person (a physiotherapist, parent, or caregiver).
Postural drainage[edit | edit source]
Postural drainage involves the positioning of the child with the assistance of gravity to mobilize secretions towards the main bronchus. Postural drainage positioning varies based on specific segments of the lungs with large amount of secretions. Before determining the postural drainage position, it is very important to auscultate the lungs and identify the lung segments where added sound ( Crepitus, ronchi) is heard. Postural drainage can be also facilitated with percussion and vibration in postural drainage position.
Modern techniques[edit | edit source]
These techniques use a variation of flow through breath control to mobilize secretions. It includes forced expiration techniques, active cycle of breathing, autogenic drainage, assisted autogenic drainage, slow and prolonged expiration, increased expiratory flow, total slow expiration with the glottis open in a lateral posture, and inspiratory controlled flow exercises.
Instrumental techniques[edit | edit source]
Instrumental techniques such as non‐invasive ventilation have been considered useful as an adjunct therapy to airway clearance and to provide respiratory support. A common instrumental technique is continuous positive airway pressure (CPAP). CPAP as be used in a conventional way via bCPAP in which positive airway pressure is given by generating a gentle air pressure via 'bubbles' in the expiratory tube submerged in an underwater system. Incentive spirometry, positive expiratory pressure, and flutter are other tools that can be used to increase lung expansion and improve gas exchange.
Indication[edit | edit source]
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Clinical Presentation[edit | edit source]
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Resources[edit | edit source]
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