Chest physiotherapy includes techniques used to loosen lung secretions, making them easier to drain or cough out. It is used when patients have difficulty breathing due to a large amount of secretions that are thick or tenacious, and cannot be effectively brought out by coughing. Conditions such as atelectasis, bronchiectasis, cystic fibrosis and pneumonia may be treated with chest physiotherapy.
Techniques used in chest physiotherapy include:
- Postural drainage: In this technique, the body is positioned or tilted in a certain angle to facilitate drainage of secretions from specific lung zones by gravity.
- Chest percussion: Percussion of the chest and back with cupped hands can help mobilize lung secretions. It is performed for 30-60 seconds or longer in case of tenacious secretions, usually following postural drainage.
- Controlled coughing: Intentional coughing in a controlled manner is performed following postural drainage. You are instructed to inhale deeply through your nose 2-3 times followed by sharp coughing, pausing intermittently.
- Vibration: Rhythmic vibrations (200 per minute) are applied to your chest by the hands of your provider or a mechanical device as you exhale.
- Deep breathing exercises: Inhaling through the nose and exhaling through pursed lips helps expand the lungs and improves aeration.
- Changing sides: Periodically changing your position from side to side while your head is elevated can assist drainage of secretions. This can be done by a caregiver in case of bedridden patients.
Chest physiotherapy may be somewhat stressful and not recommended in some conditions such as rib and spine fractures, increased head pressure, bleeding abnormalities, rib injury and certain heart diseases. Before participating in chest physiotherapy, your doctor will assess your capacity to undergo the procedure through a review of your medical history and a physical examination.