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Research ArticleConference Proceedings

Conventional Chest Physical Therapy for Obstructive Lung Disease

Cees P van der Schans
Respiratory Care September 2007, 52 (9) 1198-1209;
Cees P van der Schans
Hanze University, University for Applied Sciences, Groningen, The Netherlands
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Abstract

Chest physical therapy (CPT) is a widely used intervention for patients with airway diseases. The main goal is to facilitate secretion transport and thereby decrease secretion retention in the airways. Historically, conventional CPT has consisted of a combination of forced expirations (directed cough or huff), postural drainage, percussion, and/or shaking. CPT improves mucus transport, but it is not entirely clear which groups of patients benefit from which CPT modalities. In general, the patients who benefit most from CPT are those with airways disease and objective signs of secretion retention (eg, persistent rhonchi or decreased breath sounds) or subjective signs of difficulty expectorating sputum, and with progression of disease that might be due to secretion retention (eg, recurrent exacerbations, infections, or a fast decline in pulmonary function). The most effective and important part of conventional CPT is directed cough. The other components of conventional CPT add little if any benefit and should not be used routinely. Alternative airway clearance modalities (eg, high-frequency chest wall compression, vibratory positive expiratory pressure, and exercise) are not proven to be more effective than conventional CPT and usually add little benefit to conventional CPT. Only if cough and huff are insufficiently effective should other CPT modalities be considered. The choice between the CPT alternatives mainly depends on patient preference and the individual patient's response to treatment.

  • chest physical therapy
  • pulmonary
  • mucus transport
  • sputum
  • cystic fibrosis
  • airway secretions
  • cough
  • huff
  • postural drainage
  • autogenic drainage

Footnotes

  • Correspondence: Cees P van der Schans PhD PT CE, Hanze University, University for Applied Sciences, PO Box 3109, 9701 DC Groningen, The Netherlands. E-mail: c.p.van.der.schans{at}pl.hanze.nl.
  • Dr van der Schans presented a version of this paper at the 39th Respiratory Care Journal Conference, “Airway Clearance: Physiology, Pharmacology, Techniques, and Practice,” held April 21–23, 2007, in Cancúnn, Mexico.

  • The author reports no conflicts of interest related to the content of this paper.

  • Copyright © 2007 by Daedalus Enterprises Inc.
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Respiratory Care: 52 (9)
Respiratory Care
Vol. 52, Issue 9
1 Sep 2007
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Conventional Chest Physical Therapy for Obstructive Lung Disease
Cees P van der Schans
Respiratory Care Sep 2007, 52 (9) 1198-1209;

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Conventional Chest Physical Therapy for Obstructive Lung Disease
Cees P van der Schans
Respiratory Care Sep 2007, 52 (9) 1198-1209;
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Keywords

  • chest physical therapy
  • pulmonary
  • mucus transport
  • sputum
  • cystic fibrosis
  • airway secretions
  • cough
  • huff
  • postural drainage
  • autogenic drainage

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