Keeping your lungs clear helps prevent lung damage and chronic infections if you have cystic fibrosis, a life-threatening condition that affects an estimated 30,000 Americans, according to the Cystic Fibrosis Foundation. The condition creates thick, sticky mucus that can cause inflammation and narrowing of your airways. Chest physical therapy helps clear mucus so you can breathe easier. While various therapies exist, consult your doctor to determine which option is best for you.
Postural Drainage
Postural drainage uses gravity to help drain the mucus in your lungs to prevent serious lung infections. You sit or lie in certain positions, including sitting upright or lying with your head tilted below your lungs, so that gravity moves mucus from your lungs to your throat. Your physical therapist may then perform percussion or another technique to help remove the mucus. Lying with your head tilted below your lungs is known to cause heartburn or vomiting in some people. If you experience any of these symptoms, talk to your doctor about other therapy options.
Percussion and Vibration
Percussion, or chest clapping, and vibration are techniques that often accompany postural drainage. During percussion, your physical therapist will tap or clap against your chest and back using a cupped hand to loosen mucus. After percussion, your physical therapist may place his hand flat against your chest wall and create a vibrating motion as you exhale to shake the mucus loose. If you find this uncomfortable, opt for an inflatable vest that uses high-frequency airwaves to create vibrations along your chest wall and lungs to dislodge mucus. Alternatively, you may use devices that you breathe in and out of to help vibrate the airways and loosen the mucus. Following vibration, experts recommend a strong cough to clear the mucus.
Breathing Techniques
Breathing exercises, known as active cycle of breathing techniques, help improve airflow in the lungs by pushing mucous toward your mouth. This involves a combination of breathing control, thoracic expansion exercises and the forced expiration technique. Breathing control is normal, relaxed breathing using the lower chest and relaxed upper chest and shoulder muscles to help open your airways. Thoracic, or diaphragmatic breathing, exercises involves taking a deep, slow breath in using the diaphragm and holding it for few seconds before exhaling. This helps push the mucus up the airways. During the forced exhalation, your physical therapist will ask you to take a medium-sized breath in, then one or two fast breaths out, or "huffs," through your mouth.
Autogenic Drainage
Autogenic drainage combines three phases of breathing at low, medium and high lung volumes to move mucus out of your lungs. You can move mucus from different parts of your airways, including mucus lower down in your lungs, to a higher level where you can clear it with a gentle huff. The first phase helps unstick the mucus in your lungs, the second collects mucus and the third helps clear mucus.
Positive Expiratory Pressure
Positive expiratory pressure uses a device, consisting of a mask or mouthpiece, which connects to a one-way breathing valve or resistor to help open airways and move mucus higher up the airway. To do this, inhale normally through the mask or mouthpiece and breathe out harder against the resistive force. After eight to 12 breaths, huff up to two times or huff and cough, and use breathing control to clear mucus.
References
- Cystic Fibrosis Foundation: Adding Tomorrows Every Day
- Cystic Fibrosis Trust; Physiotherapy Treatment; September 2010
- National Heart Lung and Blood Institute: Cystic Fibrosis
- UW Health: Cystic Fibrosis Treatment --- Manual Chest Physiotherapy
- Cystic Fibrosis Foundation: Airway Clearance Techniques
- MayoClinic.com; Cystic Fibrosis; Mayo Clinic Staff; March 2, 2010
