The aim of physiotherapy is to remove excess mucous secretions so to improve ventilation.
A patient suffering from cystic fibrosis will require intensive chest physiotherapy including the following:
- Chest percussions – Otherwise known as chest clapping, chest percussions are performed by using a cupped hand to clap the chest firmly and rhythmically. Ensure that there is a layer of clothing or a towel between the chest and hand.
- Periodic assessment and monitoring – This is an important element for physiotherapy sessions as the patient may require supplemental oxygen.
- Posture drainage – This is done through gravity assisted positions e.g. use of a head down tipped position to help drainage of the secretions and also helps to increase the air movement or ventilation to different parts of the lungs.
- Shaking and vibrations – Consisting of several short rhythmical squeezes to the chest while exhaling to mobilise secretions.
ACBT and PEP
Active cycle of breathing techniques (ACBT)
ACBT is the standard airway clearance technique. The components of ACBT included breathing control, thoracic expansion exercises (percussion and/or vibration was added) and forced expiration (huff) in a set cycle. Maintain a good breathing pattern with relaxed shoulders and neck. Breathe in through nose and out through the mouth.
Positive expiratory pressure (PEP)
This technique aids in opening up th eairways while getting the air behind secretions to help move them higher up in the airway. The PEP mask/mouthpiece with give a small degree of resistance to the breathe out and this resistance splints open the airways.
In the case of young children, bubble PEP is used. This involves the child blowing through a straw placed in a bottle of water and soap to produce bubbles.
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