Chest physiotherapy breathing exercises are recommended for patients suffering from acute and chronic breathing problems such as lung disease, central nervous system disorders such as acute, chronic or progressive myopathic or neuropathy, and other problems that lead to impaired lung functioning. These exercises involve certain techniques to decrease shortness of breath; facilitate breathing, coughing and mucus removal; and train the lungs to perform more effectively.
Relaxed Positioning
Relaxed positioning is a chest physiotherapy technique that helps patients relax and reduces breathlessness, according to chest physiotherapist Pushpal Kumar Mitra's book, "Handbook of Practical Chest Physiotherapy." In this technique, the therapist assists the patient into a comfortable, relaxed position, to decrease the amount of work required to breathe in a functional, healthy manner. A seated patient is encouraged to practice specific breathing techniques while assuming a relaxed position by slumping over in a chair with the head, arms and shoulders limp and loose. The patient brings his chin as close to his chest as possible and breathes in and out through an open mouth, slowing down the breath rate and gradually increasing the length of the exhalation.
Diaphragmatic Breathing
Diaphragmatic breathing increases lung capacity, facilitates breathing and reduces the amount of work it takes to breathe comfortably. In this technique, the patient relaxes his belly and sticks it out during the inhalation, then draws it back in during the exhalation. The mouth is either left open or the lips are pursed. The patient is encouraged to relax in a supine position or a comfortable seated position so that breathing is easier.
Chest Percussion
Chest percussion is performed with the assistance of a therapist, who cups her hands and rhythmically beats on the patient's chest to encourage the release of mucus and other chest secretions. According to "Rehabilitation Nursing: Prevention, Intervention, and Outcomes," cupping the hands creates and air pocket between therapist's hands and the patient's chest, resulting in a hollow sound. Therapists usually combine this technique with relaxed positioning and other breathing techniques.
Graded Physical Exercises
Graded physical exercises promote increased lung volume. Patients who have difficulty moving or breathing often avoid any motion to counter feelings of shortness of breath. However, this becomes counterproductive, as a lack of motion decreases lung volume and breathing ability. Patients are instructed to perform certain periodic activities to strengthen respiratory muscles. Exercises can include asking a bed-ridden patient to change positions over a certain time period, or asking a patient who cannot walk to simply get herself into a chair a few times each day.
