The act of breathing is an involuntary activity that we don’t think twice about. Did you know that a defective gene in the body could lead to the production of abnormally thick, sticky mucus in the lungs? Since this coming weekend will start the month of May, which is Cystic Fibrosis (CF) Awareness Month, we are raising awareness about the fact that CF affects almost 30,000 children and adults in the United States each year, according to the cystic fibrosis foundation.
Although genetic screening and drug interventions are the mainstay of treatment, physical therapy offers tremendous benefits in helping patients get rid of mucus in the lungs and improving the ability to breathe. Physical therapy, in the form of “chest physical therapy”, can be lifesaving because the patient’s cough reflex may be too weak to forcefully cough up the mucus. A trained physical therapist can provide chest physical therapy treatment and treat an individual struggling to breathe.
“Chest physical therapy” can involve a number of different maneuvers to facilitate the removal of excessive mucus and improve breathing for individuals. Some of these include:
1. Postural Drainage – The patient is asked to lie on the side. This facilitates the movement of mucus from the deeper airways towards the larger airways owing to the effect of gravity. This makes the mucus easier to cough out. A physical therapist can teach positions and techniques, allowing patients to perform variations of postural drainage at home with minimal assistance. When combined with a unique technique called “percussion therapy”, the loosening and drainage of mucus is significant.
2. Percussion Therapy – This unique maneuver involves a series of techniques that helps clear out any infection in the chest cavity. The physical therapist cups his/her hands and gently taps the front or back of the chest wall. This effect helps dislodge mucus so it can be coughed out.
3. Vibration Therapy – Similar to percussion therapy, the hands are placed on the chest and are ‘vibrated’. This also aids in the removal of phlegm and overcome congestion.
4. Breathing Exercises – A variety of breathing patterns facilitate clearing of the airways. This involves breathing low, medium, or high volumes of air in and out of the lungs.
For example, take a shallow to medium breath in and exhale it out forcefully. This sudden diaphragm movement can push the phlegm up and out of the lungs and relieve congestion.
5. Positive Expiratory Pressure – A small mask that fits the mouth and nose is placed on the patient and air is pushed in and out of the lungs. While this can cause mild discomfort, it serves the same purpose as other techniques and facilitates the movement of air through the pulmonary tracts.
Imagine trying to breathe, but feeling an obstruction with every single breath as oxygen tries to force its way into the deeper recesses of your lungs. Imagine being constantly tired and fatigued, because your muscles are not getting the oxygen they so desperately need. That’s a day in the life of a patient with cystic fibrosis.
Deep, unobstructed breathing is something we take for granted. It’s not a luxury that patients with cystic fibrosis can enjoy. Breathing difficulties can result in other complications. The elimination of excessive, unnecessary mucus from the body with physical therapy helps prevent further complications. It helps to fight infections since excessive mucus in the lungs can harbor infective bacteria. If you or someone you know suffers from cystic fibrosis or has any difficulty in breathing there is a lot that a trained pulmonary physical therapist can do to help.
Dr. Daniel Skulavik is a physical therapist with Advanced Physical Therapy.