PHYSIOTHERAPY IN RESPIRATORY CONDITIONS

Greetings to all,

In medical field,there is vast range of therapies,Allopathy,Homeopathy, Ayurveda, PHYSIOTHERAPY, Surgery...,, etc.

In this blog I want to  discuss what's physiotherapy and physiotherapy , specifically in respiratory conditions.

Physiotherapy is treatment of disease, injury, deformity or disability to improve the quality of life.Physiotherapists uses exercise,hands on techniques and various modalities to treat the patients.

Now,various respiratory conditions e.g...
Pneumonia,Bhronchitis,Asthma,TB,Emphysema,Lung surgeries, etc...

There is protocol in physiotherapy for every condition which almost same.

First of all I would like to discuss the problems of respiratory conditions.

- Breathlessness i.e. Dysponea
- Cough production which is abnormal
- Fatigue
- Decrease in exercise tolerance

- Postural changes due to overuse of accessory muscles for respiration and decrease use of diaphragm
- Decrease in lung volumes

Goals for a Physiotherapist in respiratory conditions 

1. Removal and decrease the production of cough
2.Decrease the episodes of Breathlessness 
3.Increase exercise tolerance and decrease the level of fatigue 
4. Encourage the use of diaphragm in respiration and discourage the use of accessory muscles for respiration. 
5.Increase functional ability 

In physiotherapy there are hands on techniques, breathing techniques, aerobic exercise etc.. to treat respiratory problems.

Various techniques

1. POSITIONING-Positioning of patient involve sidelining position with good lung facing downward and bad lung facing upwards.
Positioning the patient optimize cardiovascular and cardiopulmonary function and increase ventilation of lung and increase the oxygen transport to blood i.e. perfusion.
It reduces THE WORK OF BREATHING AND HELPS TO MOBILISE AND REMOVAL OF COUGH.

2. POSTURAL DRAINAGE -Postioning the patient according to the anatomy of bronchial tree in order to use gravity to assist the drainage of secretions.

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There are some conditions in which postural drainage can't be used ,
Hypertension, Severe breathlessness, Recent surgery, Nosebleeds, Cardiac failure, Advanced pregnancy ,Recent neck trauma or surgery.

3.MANUAL CHEST CLEARANCE TECHNIQUES-These can be use while patient is in Postural drainage position. Manual techniques include Percussion, Vibration, Shaking.

4.BREATHING CONTROL TECHNIQUES-These techniques HELPS TO REDUCE WORK OF BREATHING.
Technique describes inspiration and expiration i.e.inspiration with count of 1,2 and expiration with count 1,2,3,4
These should be done with daily activities like walking, stair climbing etc.

5.ACBT ACTIVE CYCLE OF BREATHING TECHNIQUES-As name suggests it should be actively by patient, consist of 3 different techniques, NORMAL BREATHING TECHNIQUE ,THORACIC EXPANSION EXERCISES (DEEP INSPIRATION BREATHS,USUALLY COMBINED WITH 3 SECONDS OF HOLD IN INSPIRATION),FORCE EXPIRATORY TECHNIQUES INCLUDE COUGHING. There is video presentation for technique.

THESE IS DONE IN CYCLE.THESE HELPS TO CLEAR SECRETIONS FROM AIRWAYS.

6.Autogenic drainage- Its an active technique to mobilize the secretion from lower lobes and shift it to main bronchus and with help of coughing remove secretion from airway.

Stage 1- take low volume breaths through nose which mobilize the secretion from peripheral airways
Stage-2 medium volume breaths to collect mucus from middle airway
Stage 3 -large volume breaths easily remove the cough from central airways

To learn the technique watch video.

Disadvantages of the technique

Patient should over 8 years
The technique can be difficult to learn
To benefit from auditory feedback patient need to have moderate or large amount of sputum.


7.POSITIVE EXPIRATORY PRESSURE THERAPY-In this technique breathing with slightly active expiration against expiratory resistance .This is done with help of PEP device or mask.It is use to remove secretion.
Patient inspired through mask and expired through mask ,with expiration resistance is provided by device. Video of the technique

With a repeating the technique secretion are loosened and removed by coughing

Many devices which work on PEP are acapella, flutter,etc.in which oscillatory resistance is present.

8.INHALATION THERAPY-Medication delivered via nebulizer which help to clear airways .Examples of medications are antibiotics, bronchodilators,Isotonic saline,Hypertonic saline etc.

9. DIAPHRAGMATIC BREATHING-In this breathing technique patient is ask to put hands over belly and ask to take breath from nose while INSPIRATION hands on belly should go upward and chest should be relaxed and expiration is done by mouth. Watch how it's done.

10. SUCTIONING-The technique is use in patients with unconscious state and in patients who are unable to remove cough.
This technique is use by therapist or nursing staff with help of tubes connected with negative pressure which removes the secretions from main bronchus.

Positioning, Postural drainage, manual chest CLEARANCE techniques can also be done in unconscious .


11.AEROBIC EXERCISE-Aerobic exercise are taught to patient to increase exercise tolerance.

Physiotherapist can combined different techniques on different patients.

PATIENT WITH INFECTIOUS DISEASE THERAPIST SHOULD TAKE CARE OF HIMSELF. WEARING GLOVES, GOWNS, FACEMASK,HAIR MASK SHOULD BE WEARED.

PHYSIOTHERAPY CAN CURE MANY RESPIRATORY CONDITIONS AND INPROVE QUALITY OF LIFE.

STAY CONNECTED....STAY HEALTHY.......