Physiotherapy

Physiotherapy is a way of clearing the thick, sticky mucus from the lungs. Parents are taught how to do this for their child by the physiotherapist in the CF clinic. Adults with CF can learn how to administer their own physiotherapy.

Why is chest physiotherapy important?

Chest physiotherapy 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.

What different physiotherapy techniques are there?

There are a wide variety of airway clearance techniques and a Specialist CF Physiotherapist will assess a person with CF and advise on the most appropriate technique to use, and also on the length and frequency of treatment sessions. The technique used may change as you get older or as your disease changes. The amount of mucus you clear will also vary as your disease progresses.

Some techniques are done without any equipment and focus on specific breathing exercises:

• Active Cycle of breathing Techniques (ACBT)
• Autogenic Drainage

Other techniques use a device to aid clearance of mucus, by using positive pressure to hold open the airways, and some also create vibrations within the airways:

• Positive Expiratory Pressure (PEP)
• Oscillating Positive Expiratory Pressure - e.g Flutter®, Acapella®

Some techniques use large pieces of equipment which can be very expensive and therefore may only be available for use in hospital:

• High frequency chest wall oscillation (HFCWO) - an electric air compressor connects to an inflatable jacket (vest) to vibrate your chest.

How much physiotherapy is needed?

The length of treatment sessions varies according to need. Daily physiotherapy is usually required and if you have a chest infection you may need to increase the amount of airway clearance you do. If there are few or no secretions, treatment sessions may only need to last 10-15 minutes. If there are many secretions, it could take as long as 45-60 minutes.

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 physiotherapy once a day.

Your physiotherapist can advise you on how much physiotherapy is appropriate.

When should physiotherapy start?

Physiotherapy should start from the time of diagnosis.

Who should do physiotherapy?

At first, the adults that care for the child should do it. In time, relatives or friends should learn so that no one person becomes indispensable.

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.

Most teenagers become completely independent and only require help if they have increased secretions.