Chest physical therapy

Chest physical therapy is the term for a group of treatments designed to promote expansion of the lungs, strengthen respiratory muscles, and eliminate secretions from the respiratory system. The purpose of chest physical therapy, also called chest physiotherapy, is to help patients breathe more freely and to get more oxygen into the body.

A chest physical therapy program includes postural drainage, chest percussion, chest vibration, turning, deep breathing exercises, and coughing. It is usually done in conjunction with other treatments to rid the airways of secretions. These other treatments include suctioning, nebulizer treatments, and theadministration of expectorant drugs.

Turning from side to side permits lung expansion. Patients may turn themselves or be turned by a caregiver. The head of the bed is also elevated topromote drainage if the patient can tolerate this position. Critically ill patients and those dependent on mechanical respiration are turned once every one to two hours around the clock.

Coughing helps break up secretions in the lungs so that the mucus canbe suctioned or spit out. Patients sit upright and breath in (inhale) deeplythrough the nose. Then they breath out (exhale) in short puffs or coughs. Coughing is repeated several times a day.

Deep breathing helps expand the lungs by forcing better distribution of the air into all sections of the lung. The patient either sits in a chair or sits upright in bed and inhales while pushing the abdomen out to force maximum amounts of air into the lung. The patient then exhales while contracting,or pulling in, his abdomen. Deep breathing exercises are done several timeseach day for short periods.

Postural drainage involves draining secretions from the lungs into the airway where they can either be coughed up or suctioned out. The patient isplaced in a head or chest down position and is kept in this position for upto 15 minutes. Critical care patients and those depending on mechanical ventilation receive postural drainage therapy four to six times daily. Percussionand vibration may be performed in conjunction with postural drainage.

Percussion is rhythmically striking the chest wall with cupped hands.It is also called cupping, clapping, or tapotement. The purpose of percussionis to break up thick secretions in the lungs so that they can be more easilyremoved. Percussion is performed on each lung segment for one to two minutesat a time.

As with percussion, the purpose of vibration is to help break up lungsecretions. Vibration can be either mechanical or manual. A vibrating device(mechanical) or quickly moving hand (manual) is pressed up against the chestwhile the patient exhales. The procedure is repeated several times each day for about five breaths.

People who have medical conditions that make it difficult to clear secretionsfrom their lungs can often benefit from chest physical therapy, including those with cystic fibrosis or neuromuscular diseases like Guillain-Barr├ęsyndrome, progressive muscle weakness (myasthenia gravis), or tetanus. People with lung diseases such as bronchitis, pneumonia, or chronic obstructive pulmonary disease (COPD) may also benefit from chest physical therapy. People who are likely to aspirate their mucous secretions because of diseases such ascerebral palsy or muscular dystrophy also receive chest physical therapy, asdo some people who are bedridden, confined to a wheelchair, or who cannot breath deeply because of postoperative pain.

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