Chest Physiotherapy

What is Chest Physiotherapy?
Chest physiotherapy (CPT) is a treatment that helps clear mucus from both large and small airways in the lungs. It also helps the parts of the lung that aren't getting enough air to expand fully.

Objectives of Chest Physiotherapy:

• Achieve results similar to bronchoscopy without the need for invasive procedures, avoiding trauma, complications, and high costs.
• Improve airflow in areas of the lung that are blocked.
• Help the lungs expand more in areas that were not fully ventilated, which can improve blood flow to those areas.
• Clear mucus from the airways, making it easier to breathe and improving oxygen levels.
• Reduce the risk of lung infections after surgery, decrease complications, and shorten hospital stays for people with lung conditions.

Techniques Used in Chest Physiotherapy:

1. Diaphragmatic Breathing: Focuses on using the diaphragm, the main breathing muscle, to breathe efficiently. This reduces the effort needed to breathe and increases oxygen levels. It also helps clear mucus when combined with other techniques like postural drainage.
2. Incentive Spirometry: Involves taking deep breaths using a special device that provides feedback. This helps improve lung capacity and prevents lung collapse.
3. Segmental Breathing:
• Lateral Costal Expansion: Focuses on deep breathing to move the lower rib cage. It helps the diaphragm work better, especially useful for people with stiff rib cages due to conditions like bronchitis, emphysema, or asthma.
• Posterior Basal Expansion: Important for patients who are bedridden, as it helps clear mucus that tends to collect in the back parts of the lungs.
4. Glossopharyngeal Breathing: Teaches patients with weak breathing muscles how to take deeper breaths, which is especially helpful for those with spinal cord injuries who are at risk of respiratory problems.
5. Pursed Lip Breathing: Involves breathing out through tightly pressed lips. This keeps the airways open longer, which helps people with COPD manage shortness of breath and improves their exercise capacity.
6. Postural Drainage: Uses different body positions to let gravity help drain mucus from specific lung areas to the larger airways, where it can be coughed out or suctioned.
7. Percussion: Involves gently clapping on the chest with cupped hands to loosen mucus in the lungs, making it easier to cough out.
8. Vibration: Uses gentle shaking of the chest during exhalation to help move mucus toward the larger airways. This technique is often used with postural drainage.
9. Coughing: A natural way to clear mucus from the airways. It's the fastest method to remove mucus, especially important for patients with respiratory conditions.
10. Suctioning: Removes mucus from the airways when patients can't cough effectively on their own. It's often used for patients with a breathing tube or those who can't clear their airways on their own.
11. Positive Expiratory Pressure (PEP): Uses a device that creates pressure in the airways when you breathe out, helping to keep them open and clear mucus. This method is especially useful for children over four who can follow instructions.

Conditions Treated with Chest Physiotherapy:

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Bronchitis
• Bronchiectasis (damaged airways)
• Atelectasis (collapsed lung)
• Lung abscess (pocket of pus)
• Pneumonia
• Cystic fibrosis (a genetic disorder that affects the lungs)
• Emphysema
• Difficulty breathing

When Not to Use Chest Physiotherapy (Contraindications):

• Unstable vital signs, such as blood pressure or oxygen levels
• Recent heart attack or unstable heart condition
• Lung tumors or active tuberculosis
• High pressure in the brain or recent head injuries
• Recent surgeries, especially on the spine or chest
• Conditions like osteoporosis in the chest area, rib fractures, or severe bleeding
• Pregnancy or certain abdominal conditions like aortic aneurysm
• Uncontrolled high blood pressure or severe lung problems like pulmonary embolism