Expulsive Phase

Question 1

What is the expiratory phase in physiotherapy treatment options?

Answer 1

• Manual Assisted Cough (MAC)

The expiratory phase involves techniques to enhance cough effectiveness.

Question 2

Define Manual Assisted Cough (MAC).

Answer 2

A manually assisted cough manoeuvre involving abdominal thrust or costal lateral compression after inspiration

This technique is used to increase peak cough flow (PCF) in neuromuscular diseases (NMD).

Question 3

What are the key components of the MAC technique?

Answer 3

• Position of patient
• Sustained pressure
• Optimal coordination

Coordination is essential between therapist(s) and patient cough effort.

Question 4

True or false: Manual Assisted Cough (MAC) can be combined with the MIC technique to optimize results.

Answer 4

TRUE

This combination is recommended by ACPR/BTS Guidelines, 2009.

Question 5

What does MI:E stand for in physiotherapy treatment options?

Answer 5

A technique that increases inspiratory volume and expiratory flow

MI:E delivers gradual inspiratory positive pressure followed by rapid negative expiratory pressure to simulate a cough.

Question 6

List the benefits of MI:E.

Answer 6

• Increases inspiratory volume
• Increases expiratory flow
• Generates adequate shearing forces to loosen and move secretions

This technique is supported by research from Chatwin and Simonds (2009) and Homnick (2007).

Question 7

What is the purpose of gradual inspiratory positive pressure in MI:E?

Answer 7

To simulate a cough

This is followed by a rapid shift to negative expiratory pressure.

Question 8

What are the two methods of manually assisted cough mentioned?

Answer 8

• Thoracic compression
• Abdominal-thoracic compression

These methods are used to enhance the effectiveness of the cough.

Question 9

Fill in the blank: Manual Assisted Cough (MAC) is used to increase _______ in NMD.

Answer 9

PCF

PCF stands for peak cough flow.