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Cystic Fibrosis in Australia

Physiotherapy

Physio

Airway Clearance Techniques

Chest Percussion

This technique aids clearance of secretions up and out of the lungs and increasing the amount of air entering the lungs. A cupped hand is used to clap the chest firmly (it is more comfortable through clothing or a towel). Chest percussion is often combined with the above postural drainage positions. Parents or carers will be taught the chest percussion and other friends can be taught as the person with CF becomes an adult.

Why is chest percussion important?
  • Chest percussion is important because helps to prevent the thick, sticky lung secretions from blocking the air tubes. This helps to reduce infection and prevent lung damage.
How much chest percussion is needed?
  • The length of treatment sessions varies according to need. If there are few or no secretions, treatment sessions may only need to last 10-15 minutes. However, it could take as long as 45-60 minutes if there are many secretions to be cleared.
  • The number of treatment sessions should be varied. Most people do two a day when all is well, increasing to four a day when necessary. If no secretions are present, some people with CF only need treatment once a day.
  • Your physiotherapist can advise you on how much chest percussion is appropriate.
When should chest percussion start?
  • The CF specialist will advise on when to begin chest percussion.
Who should do chest percussion?
  • At first the adults that care for the child should do it. Later on, relatives or friends should learn so that no one person becomes indispensable.
  1. Breathing exercises can be introduced in the form of a game from the age of two or three. From around the age of nine, most children can start doing part of their physiotherapy for themselves.
  2. Most teenagers become completely independent and only require help if they have increased secretions.

Vibrations

These are usually done in a drainage position in alternation with percussion. "Vibes" are a gentle shaking or vibrating of the chest whilst breathing out. This creates mini bursts of air flow which dislodge the secretions, moving them up and out of the airways. They are usually followed by a huff or cough in combination, to clear secretions from the lungs.

Breathing Techniques (The Active Cycle of Breathing Techniques)

A physiotherapist can teach a variety of breathing techniques. These techniques use controlled deep and shallow breathing to move mucus up through the airways. Breathing techniques are also used to help re-inflate any areas of the lungs which may have been deflated because of mucus blockage of the airways.

Flutter Therapy

This technique uses a handheld oscillating positive pressure device through which you breathe out against an alternating resistance. This causes back pressure which results in expansion of the small airways, keeping them open for longer, whilst mini bursts of air flow move secretions out of the small airways and into larger airways where they can be cleared with a huff of cough in combination.

Positive Expiration Pressure (PEP)

PEP therapy involves breathing out though a mask or mouthpiece where a backpressure is created in the lungs by only allowing air out through a small hole. This back pressure expands the small airways and opens side channels (collateral ventilation) to get behind secretions, moving them to larger airways where they can be cleared.

Autogenic Drainage

This technique was developed in Belgium and is a controlled method of breathing that requires no equipment.  It involves training to breathe at three lung volumes:

This technique requires extensive training and frequent practice.

Always ask your doctor before considering any change in your treatment.

Emmah Money

Emmah Money

"I want everyone to know about Cystic Fibrosis. At least 30% of teenagers with the disease pass away and I have lost many childhood friends from the condition" Emmah Money - Cystic Fibrosis Ambassador and 2005 Girlfriend of the Year winner.

 
Mother with toddler on her knee sitting on the bed

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