A method used tomobilize or loosensecretions in the lungsand respiratory tract.
Chest Physiotherapy
Goals of CPT
- Prevent accumulation of secretions
- Improve mobilization and drainage of secretions
- Promote relaxation to improve breathing pattern
- Promote improved respiratory function
- Improve cardiopulmonary exercise tolerance
Indications of CPT
- Cystic Fibrosis
- Bronchiectasis
- Atelectasis
- Lung Abscess
- Neuromuscular diseases
- Pneumonia’s in dependent lung regions
Positioning the patient to allow gravity and mechanical energy to drain a specific lung segment.
- Duration: 3-15minutes or longer and modified depending the patient’s condition and tolerance.
Postural drainage
Indications of Postural drainage:
- Lung condition that cause increased difficulty in mobilizing pulmonary secretions
- Bronchiectasis
- Cystic Fibrosis
- Acute atelectasis
- Ventilation and perfusion abnormalities resulting from retained pulmonary secretions
Contraindications of postural drainage:
- Patients with ICP greater than 20mmhg
- Head and neck injury(until stabilized)
- Recent spinal surgery or injury
- Rib fractures
- Active hemoptysis
- Tube feeding or recent meal
- Pulmonary Tuberculosis
Hazards and Complications of postural drainage:
- Hypoxemia
- Increased ICP
- Acute hypotension
- Pain or injury to the muscles, ribs, spine
- Arrythmias
- Bronchospasm
- Vomiting
- Aspiration
involves striking the chest wall over the area being drained.
- involves the use of cupped palm to loosen pulmonary secretions so that hey can be expectorated with ease.
Percussion
Rhythmically strike the chest wall in a waving motion, using both hands alternately in sequence with elbows partially flexed and wrists loose.
- Duration: 3 to 5 minutes
Manual Percussion
Sites to be avoided in Perscussion
- Spine
- Sternum
- Scapulae
- Clavicle
- Surgical site
- Areas of trauma
- Bare skin
Aids in movement of secretions toward the central airways during exhalation
- The patient should be instructed to take a deep breath and vibration should be applied during exhalation
Vibration
Place one hand on top of the other over a specified lung segment and with a vibrating motion, applying moderate pressure
Manual Vibration
Contraindications of Vibrations
- Fractured ribs
- Pulmonary Tuberculosis
- Recent heart attack
- Hemorrhagic conditions
- Lung metastases
- Brittle and fragile bones
- Empyema
Aims to mimic the features of an effective spontaneous cough in patients who are too weak to produce a forceful expiratory maneuver.
Most effective in clearing secretions in central and peripheral airways.
Directed Cough
Indications of Directed cough
- Atelectasis
- Post-op prophylaxis
- Secretion retention
- Sputum Sampling
Hazards and Complications of Directed cough
- Vomiting
- Headache
- Fatigue
- Bronchospasm
- Muscular damage or discomfort
- Cough paroxysms
- Incontinence
