respiratory physiotherapy

Respiratory physiotherapy is a core specialty within the physiotherapy profession and occupies a key role in the management and treatment of patients with respiratory diseases. It aims to unclog the patient’s airways and help them return to physical activity and exertion. The respiratory physiotherapist employs many diverse interventions, including pulmonary rehabilitation, early mobilisation, and airway clearance techniques, all having beneficial effects on the symptoms associated with respiratory diseases.

respiratory CONDITIONS

EMPHYSEMA

Breathlessness is a symptom of the lung disease emphysema. Alveoli, the lungs, air sacs, suffer damage in those with emphysema. The air sacs; inner walls deteriorate and tear over time, resulting in the creation of fewer, larger air gaps as opposed to more, smaller ones. As a result, less oxygen enters your bloodstream because of a reduction in lung surface area.

Causes
Emphysema is primarily brought on by chronic exposure to allergens in the air, such as:
cigarette smoke
Cannabis smog
air toxicity
Dust and chemical fumes

Symptoms
Breathlessness is the primary symptom of emphysema, and it often develops gradually because you might begin to avoid activities that make you feel out of breath, the symptom might not be a concern until it starts to interfere with everyday activities. Shortness of breath inevitably develops, even when you're at rest.

PT management
Pulmonary rehabilitation, which involves education, nutrition counselling, learning specific breathing methods, assistance with quitting smoking, and beginning an exercise routine, is a crucial component of the treatment of emphysema. Emphysema patients frequently have physical limitations, thus they may avoid engaging in any physical activity.

ASTHMA

Introduction

It is a non-communicable disease of airways that is characterized by increased responsiveness of the tracheobronchial tree to a variety of stimuli resulting in widespread spasmodic narrowing of the air passages.

Causes

- Allergens, pollutant infection, Inflammation
- Genetic factors such as cytokine response profile

Symptoms
- Wheezing
- Shortness of breath
- Chest tightness
- Dyspnea
- Cough

Physiotherapy management

- Respiratory muscle training with breathing exercises
a. Controlled breathing technique
b. Pursed lip breathing
- Postural drainage therapy includes
a. Positioning
b. Postural drainage
c. Percussion
d. Vibration
e. shaking
- Active cycle breathing technique ( ACBT )
- Forced expiratory technique
- Dyspnea relieving positions
a. Forward lean sitting
b. Forward lean standing
c. Relaxed standing, sitting
d. Side lying
e. High side lying

BRONCHITIS

DEFINITION
• Inflammation of the walls of the bronchi that carry air to the lungs.

CAUSES
• Viral infections
• Cigarette smoking
• Air pollution
• Toxic gases
• Dust

CLINICAL FEATURES
• cough
• sputum production
• wheezing
• chest pain
• Fatigue

PHYSIOTHERAPY MANAGEMENT
• Postural drainage
• Percussion
• Vibration
• Shaking
• Breathing exercises
• Coughing and huffing exercises

CHRONIC BRONCHITIS

Introduction
It is an inflammatory condition that occurs in the lining of the bronchial tubes. It is commonly seen in smokers. And their lungs will be infected. There is acute and chronic bronchitis. Chronic bronchitis is the most serious condition.

Causes
Smoking is the primary cause of persistent bronchitis. The secondary cause is environmental and air
pollution. Other lung conditions like:-
Asthma
Respiratory emphysema
Lung irritation
Sinusitis
Tuberculosis
Upper respiratory illnesses

Symptoms
Symptoms can vary from person to person. Some signs include:-
Cough, also known as the smoker's cough
Making mucus cough (expectoration)
Wheezing
Uncomfortable chest

Physiotherapy management
The treatment protocol includes respiratory physical therapy and pulmonary rehabilitation. Exercises that improve functional abilities, increase energy levels, clear blocked airways, and aerobic exercise, upper and lower limb resistance training. Before beginning any fitness program, patients should consult their general practitioner and be under the care of the treating healthcare team, such as a physiotherapist.

COPD

Chronic obstructive pulmonary disease (COPD) is a common and treatable disease characterized by progressive airflow limitation and tissue destruction. Chronic inflammation causes airway narrowing and decreased lung recoil.

COPD includes Bronchitis, Emphysema

SYMPTOMS
 Cough
 Sputum Production
 Symptoms can range from being asymptomatic to respiratory failure.
 suffocation and chest tightness.
 Shortness of breath, especially during physical activities
 Frequent respiratory infections
 Lack of energy
 Unintended weight loss (in later stages)
 Swelling in ankles, feet or legs

CAUSES
 Smoking
 Occupational exposure – coal mining, gold mining, cotton textile industry
 Air pollution

PHYSIOTHERAPY MANAGEMENT
 Positioning
 Oxygen therapy
 Pursed lip breathing
 Postural drainage
 Unsupported arm exercises
 Inspiratory muscle training
 Diaphragmatic breathing
 Incentive spirometry
 Endurance training
 Strength training
 Flexibility training
 Postural correction exercises

CYSTIC FIBROSIS

Cystic fibrosis is a serious inherited condition that makes outrageous mischief the respiratory and stomach related structures. This mischief much of the time results from an improvement of thick, shabby natural liquid in the organs.

SYMPTOMS
• Rehashing chest sicknesses
• Wheezing, hacking, shortness of breath and mischief to the flight courses
• Inconvenience putting on weight and creating
• Yellowing of the skin and the whites of the eyes
• Detachment of the guts, stoppage, or tremendous, malodorous poop
• A stomach obstruction in newborn children - operation may be required

CAUSES
A disfigurement (change) in a quality — the cystic fibrosis Trans film conductance regulator (CFTR) quality

PHYSIOTHERAPY MANGEMENT
• Chest Physiotherapy
• Active cycle of breathing
• positioning
• Breathing Control
• Thoracic expansion exercises
• Forced Expiration Technique
• Positive expiratory pressure
• Oscillating PEP
• Gentle huffing
• Minimize coughing
• Aerobic exercises

PLEURISY

INTRODUCTION
• pain over the chest in association with the covering of lungs.

CAUSES
• Infection by a virus
• Infection by a bacteria
• Any other problems affecting lungs.

SYMPTOMS
• Sharp chest pain makes us to take small shallow breaths .
• Pain radiates to shoulder or back.
• Cough
• Fever and shivering .

PHYSIOTHERAPY MANAGEMENT
• Secretion clearance -Postural drainage in sitting and lying.
• Breathing exercises -Diaphragmatic breathing exercises.
• Patient education and advice.

PNEUMONIA

Introduction
Pneumonia is a general term that refers to the infection of the lung cells. It can be bacterial, viral of fungal infection.

Symptoms
o Common symptoms such as fever, cough, sputum production (may or may not be present)
o Chest pain.
o Body weakness, headache, muscle pain, joint pain.
o If there is severe pneumonia, there will be shortness of breath, confusion, infection in blood, increased heartbeat and decreased oxygen content in blood.

Causes
o Bacterial pneumonia – Pneumonia causing bacteria masses and multiplies in lungs.
o Fungal pneumonia – Typically occurs in people with weakened immune system or other underlying health issues.
o Viral pneumonia – virus is the cause of half of all the cases of pneumonia.
o Community acquired pneumonia – occurs as communicable diseases.
o Hospital acquired pneumonia – it is ventilator associated pneumonia. It can be developed by bacterial multiplication on endotracheal tube.
o Aspiration pneumonia – Caused by inhaling a foreign object, vomit, mucus, bodily fluids or certain chemicals which cause lungs to become infected.

Physiotherapy Treatment
o Pulmonary rehabilitation
 Postural drainage
 Suctioning
 Lung secretion clearance techniques.
o Breathing exercises
o Early mobilization

WHEN DOES THE PATIENT REQUIRE RESPIRATORY PHYSIOTHERAPY ?

Inability or reluctance of the patient to change body position. (eg, mechanical ventilation, neuromuscular disease, drug-induced paralysis).
Poor oxygenation associated with the position (eg, unilateral lung disease).
Potential for or presence of atelectasis.
Presence of artificial airway.

Difficulty clearing secretions with expectorated sputum production greater than 25-30 mL/day (adult).
Evidence or suggestion of retained secretions in the presence of an artificial airway.
Presence of atelectasis caused by or suspected of being caused by mucus plugging.
Diagnosis of diseases such as cystic fibrosis, bronchiectasis, or cavitating lung disease
Presence of foreign body in the airway.
Patient with copious sputum or with central consolidation.

WHAT ARE THE BENEFITS OF RESPIRATORY PHYSIOTHERAPY ?

Respiratory therapy can shorten the recovery time from acute conditions, such as a respiratory infection, allergy related breathing issues, and influenza. Respiratory therapy can work along with other treatments to expedite the healing process and get patients back to their normal activities.

Here are five benefits that prove how valuable respiratory therapy is,

Faster Healing
Improved Immune Function
Pharmaceutical Alternatives
Individualized Care
Return to Daily Activities

Bethany Navajeevan Physiotherapy Clinic
& Rehabilitation Centre

'Learn to Heal' with Care & Compassion