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Vimukthi Chandula

Importance of chest physiotherapy



What is chest physiotherapy?

  • Chest physiotherapy is the term for a group of treatments designed to eliminate secretions, thus helping to decrease work of breathing, promote the expansion of the lungs, and prevent the lungs from collapse.

  • It is the important adjuvant treatment of most respiratory illnesses from chronic respiratory diseases ( COPD, bronchiectasis, cystic fibrosis), neuromuscular diseases (muscular dystrophy, cerebral palsy, spinal cord injury), and during peri-operative care mainly in upper abdominal surgeries. Chest physiotherapy can be a valuable component of comprehensive respiratory care but only if used when indicated.

  • Chest physiotherapy is one way to reduce the risks of an inefficient clearance of airway secretions. Depending on the specific technique and health situation, it may be used on children from newborns to adolescents.


Aims of Chest Physiotherapy.


  • Chest physiotherapy helps patients breathe more freely and to get more oxygen into the body.

  • It includes postural drainage, chest percussion, chest vibration, turning, deep breathing exercises, and coughing.

  • Chest physiotherapy is normally done in conjunction with other treatments to rid the airways of secretions.

  • These other treatments include suctioning, nebulizer treatments, and the administering expectorant drugs.

 

The purpose of chest physiotherapy is

  • To facilitate removal of retained or profuse airway secretions.

  • ️ To optimize lung compliance and prevent it from collapsing.

  • ️ To decrease the work of breathing.

  • ️ To optimize the ventilation-perfusion ratio/ improve gas exchange.


Necessity of chest physiotherapy

 

️ The following should be assessed together to establish a need for chest physiotherapy:

  • Excessive sputum production.

  • Effectiveness of cough.

  • History of pulmonary problems treated successfully with PDT (eg, bronchiectasis, cystic fibrosis, lung abscess).

  • Decreased breath sounds or crackles suggesting secretions in the airway.

  • Change in vital signs.

  • Abnormal chest x-ray consistent with atelectasis, mucus plugging, or infiltrates.

  • Deterioration in arterial blood gas values or oxygen saturation.

 

The following can be achieved as a result of chest physiotherapy.

  • Change in sputum production.

  • ️ Change in breath sounds of lung fields.

  • ️ Patient subjective response to therapy.

  • Change in vital signs.

  • ️ Change in chest x-ray.

  • ️ Change in arterial blood gas values or oxygen saturation.

  • ️ Change in ventilator variables.

  • ️ Change in Modified borg scale- dyspnea level.

  • ️ Change in Peak Expiratory Flow Rate.


References

http://www.healthofchildren.com/C/Chest-Physical-Therapy.html


Sehani madhushika.

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