Chest physiotherapy for respiratory health

Some conditions make breathing difficult because they make the mucus in your lungs become thick, sticky or just excessive. These conditions can be uncomfortable or even life-threatening if they’re severe.

At Aurora Health Care, we offer effective chest physiotherapy methods to help you breathe more easily when you have such a condition.

What is chest physiotherapy?

Chest physiotherapy includes techniques and devices used to make it easier to cough up excess, thick or sticky mucus from your lungs. Some of them work to break up the mucus using vibration or by applying percussion (force) to the area of the lungs has mucus. Other techniques work by increasing the strength of your breathing.

Traditional chest physiotherapy

Conventional or traditional chest physiotherapy techniques were first developed over a century ago. These methods have evolved over time. Now they may be used along with bronchodilator therapy or pulmonary rehabilitation treatment plans.

Lungs normally have a thin layer of mucus that picks up particles that need to be removed. The mucus is gradually moved across the lung tissues by tiny hair-like structures called cilia. Eventually, the secretions make their way to the trachea and pharynx where they can be expectorated (spit out) or swallowed.

Conventional chest physiotherapy consists of a combination of postural drainage, percussion and vibration (PDPV).

• Postural drainage uses different body positions and gravity to help drain mucus. The therapist begins by listening to your lungs using a stethoscope to find where your lungs have mucus. Then they’ll put you in a position to help drain mucus from those places.
• Percussion is delivered by a therapist who uses a cupped hand to hit your back in a steady rhythmic pattern over the area of your lungs that has excess mucus. The pattern starts at the bottom of the lungs and moves toward the top. Family members may be taught to do this technique for people who need it.
• Vibration is provided using a gentle back and forth motion with a hand that’s held flat against your back.

These methods help break up and drain mucus. Coughing is a natural assistant to removing mucus from the lungs. But when the mucus becomes excessive, thick or sticky, coughing may not be enough. Other breathing techniques may be needed to help get the mucus out of your lungs.

Other breathing techniques

The forced expiratory technique (FET), sometimes called huffing, has been shown to be more effective for removing mucus from the lungs than coughing. It’s a pattern of breathing exercises where you breathe in deeply and then breathe or blow out forcefully through your mouth.

Another breathing method is the active cycle of breathing technique (ACBT). It uses breathing control methods and chest expansion along with the FET.

Conditions that benefit from chest physiotherapy

Doctors may recommend chest physiotherapy for lung or neuromuscular conditions that produce excess, thick or sticky mucus that must be removed from the lungs. Some of those conditions are:

• Bronchiectasis
• Cerebral palsy
• Chronic obstructive pulmonary disease (COPD)
• Cystic fibrosis
• Muscular dystrophy
• Pneumonia
• Spinal cord injury

You may also have chest physiotherapy techniques recommended before some upper abdominal surgeries.

Regardless of your condition or disease, you’ll be recommended for these airway clearance techniques based on the following signs, tests and health history details:

• Abnormal chest X-rays
• Changes in your vital signs
• Evaluation of the sounds of your breathing
• History of successful postural drainage treatment
• How much mucus you cough up from your lungs
• Whether your coughing is effective in bringing up mucus
• Worsening of oxygen levels in your blood

Benefits of chest physiotherapy

Any of these airway clearance techniques are recommended to improve your quality of life and respiratory health. Expected benefits are:

• Improved coughing to expel mucus
• Improved physical fitness
• Lung function improvement
• Prevention of secondary respiratory complications
• Reduced difficulty with breathing

Risks of chest physiotherapy

As with any medical procedure, there are risks associated with chest physiotherapy techniques. You may experience pain or an injury to the muscles, ribs or spine. Low levels of oxygen in the blood (hypoxemia) sometimes happen.

Some other possible complications are:

• Abnormal heart rhythms
• Acute low blood pressure
• Hemorrhage in lungs
• Increased pressure in the head
• Spasms in the bronchial tubes
• Vomiting

Your Aurora Health Care team will monitor you carefully while you’re receiving chest physiotherapy. If there are any signs of complications, they’ll respond quickly to protect your health.

Chest physiotherapy devices

Your doctor may recommend various devices to help remove sticky or thick mucus from your lungs. These devices have been developed based on clinical experience and research. For example, devices commonly used to treat sleep apnea can be used in a different way to improve your ability to clear mucus from your lungs. Some of the more common devices are:

• Continuous positive airway pressure (CPAP): Device may be used to apply pressure against exhalations. When you use it repeatedly, your muscles become stronger so you can exhale more air and mucus.
• High-frequency chest wall oscillation (HFCWO): Chest physiotherapy vests or wraps that inflate and deflate in a steady rhythm to produce percussion on the lungs that is delivered at the precise pressure and frequency desired. May be used with a nebulizer.
• Intrapulmonary percussive ventilation (IPV): Device uses a mouthpiece to deliver timed bursts of pressurized air into the lungs. The flow of air also helps remove mucus.
• Positive expiratory pressure (PEP): Devices that allow inhaling with no pressure but apply pressure against any exhalation. With practice, they make your muscles stronger and increase the amount of air you can exhale and mucus you can remove.