Chest physiotherapy (CPT) are treatments generally performed by

physical therapists Physical therapy (PT), also known as physiotherapy, is a healthcare profession, as well as the care provided by physical therapists who promote, maintain, or restore health through patient education, physical intervention, disease prevention ...

and

respiratory therapist A respiratory therapist is a specialized healthcare professional, healthcare practitioner trained in Intensive care medicine, critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical condit ...

s, whereby

breathing Breathing (spiration or ventilation) is the rhythmical process of moving air into ( inhalation) and out of ( exhalation) the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxy ...

is improved by the indirect removal of

mucus Mucus (, ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both Serous fluid, serous and muc ...

from the breathing passages of a

patient A patient is any recipient of health care services that are performed by Health professional, healthcare professionals. The patient is most often Disease, ill or Major trauma, injured and in need of therapy, treatment by a physician, nurse, op ...

. Other terms include respiratory or cardio-thoracic physiotherapy. CPT are treatments which are performed on people who have mucus dysfunction in

respiratory disease Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, ...

conditions like

asthma Asthma is a common long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wh ...

chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by chronic respiratory symptoms and airflow limitation. GOLD defines COPD as a heterogeneous lung condition characterized by chronic respiratory s ...

bronchitis Bronchitis is inflammation of the bronchi (large and medium-sized airways) in the lungs that causes coughing. Bronchitis usually begins as an infection in the nose, ears, throat, or sinuses. The infection then makes its way down to the bronchi. ...

bronchiectasis Bronchiectasis is a disease in which there is permanent enlargement of parts of the bronchi, airways of the lung. Symptoms typically include a chronic cough with sputum, mucus production. Other symptoms include shortness of breath, hemoptysis, co ...

and

cystic fibrosis Cystic fibrosis (CF) is a genetic disorder inherited in an autosomal recessive manner that impairs the normal clearance of Sputum, mucus from the lungs, which facilitates the colonization and infection of the lungs by bacteria, notably ''Staphy ...

. These respiratory conditions all have a common requirement of chest physiotherapy to assist the mucus clearance due to defects with

mucociliary clearance Mucociliary clearance (MCC), mucociliary transport, or the mucociliary escalator describes the self-clearing mechanism of the respiratory tract, airways in the respiratory system. It is one of the two protective processes for the lungs in removi ...

. Techniques include chest percussion using

clapping A clap is the percussive sound made by striking together two flat surfaces, as in the body parts of humans or animals. Humans clap with the palms of their hands, often quickly and repeatedly to express appreciation or approval (see applause), bu ...

: the therapist lightly claps the patient's

chest The thorax (: thoraces or thoraxes) or chest is a part of the anatomy of mammals and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main di ...

back The human back, also called the dorsum (: dorsa), is the large posterior area of the human body, rising from the top of the buttocks to the back of the neck. It is the surface of the body opposite from the chest and the abdomen. The vertebral c ...

, and area under the arms. Percussion, while effective in the treatment of infants and children, is no longer used in adults due to the introduction of more effective and self-management focused treatments. These include oscillating positive expiratory pressure devices or OPEP devices like "Flutter", "Aerobika", "AirPhysio", "Pari O-PEP", or positive expiratory pressure PEP devices like the "Acapella" and PEP masks or devices for

positive airway pressure Positive airway pressure (PAP) is a mode of respiratory ventilation used in the treatment of sleep apnea. PAP ventilation is also commonly used for those who are critically ill in hospital with respiratory failure, in newborn infants (neonates), ...

, as well as specific

exercise Exercise or workout is physical activity that enhances or maintains fitness and overall health. It is performed for various reasons, including weight loss or maintenance, to aid growth and improve strength, develop muscles and the cardio ...

regimes. The exercises prescribed can include specific respiratory exercises, for example autogenic drainage, as well as general cardiovascular exercises that assist the body to remove sputum and improve the efficiency of

oxygen Oxygen is a chemical element; it has chemical symbol, symbol O and atomic number 8. It is a member of the chalcogen group (periodic table), group in the periodic table, a highly reactivity (chemistry), reactive nonmetal (chemistry), non ...

uptake in

muscle Muscle is a soft tissue, one of the four basic types of animal tissue. There are three types of muscle tissue in vertebrates: skeletal muscle, cardiac muscle, and smooth muscle. Muscle tissue gives skeletal muscles the ability to muscle contra ...

s. There is no strong evidence to recommend chest physiotherapy as a routine treatment for adults who have

pneumonia Pneumonia is an Inflammation, inflammatory condition of the lung primarily affecting the small air sacs known as Pulmonary alveolus, alveoli. Symptoms typically include some combination of Cough#Classification, productive or dry cough, ches ...

. The objectives of chest physiotherapy are twofold. First, to obtain outcomes equal to and more effective than bronchoscopy without the invasiveness, trauma, and risk of hypoxemia, the complications of physician involvement, and the cost that bronchoscopy requires. Second, to specifically improve ventilation to areas of local lung obstruction. If the objectives of the chest physiotherapy are achieved, an increase in local lung expansion should occur, and a parallel increase in perfusion to the affected area would result. If secretions are cleared from larger airways, airway resistance and obstruction should decrease. Clearance of secretions and improved ventilation of small airways should increase lung compliance. If clearance of secretions from both large and small airways occurs, it is reasonable to assume that the work of breathing and oxygen consumption should decrease and that gas exchange improve. Further, if these objectives are achieved, the incidence of postoperative respiratory infection, morbidity, and hospital stay for those with acute and chronic lung diseases should be reduced.

References

Physical therapy Respiratory system procedures {{Treatment-stub

See also

References