How can I do chest physio at home?

Chest physiotherapy is a treatment you receive when you have anything from a sinus infection all the way through to pneumonia or a collapsed lung. In the hospital, if you need chest physio, you will most likely receive the treatment twice a day. Once you are discharged, however, you may need to follow up with a physio in his/her outpatient practice. Going through there twice a day may not be practical. 

If you have not been admitted to hospital for your problem, you may still want to double up on your outpatient physio session with a home version. 

Chronic lung conditions like Cystic Fibrosis, Asthma or Emphysema, require daily physiotherapy sessions that you may not necessarily be able to do. How can you manage chest therapy at home?

Step 1 – Nebulise (steaming)

The easiest method of doing this is with a nebuliser machine. You can pick these up at your local pharmacy at any price from reasonable to very expensive – it all depends on your need. If you have a chronic condition, it may be worth your while to invest in one. Some pharmacies also rent out the nebulisers if you only need it for a once off occasion. 

   

If you do not have a nebuliser, or cannot get hold of one, you can go old school. A good old steam will also do the trick. You can either pour some steaming hot water into a bowl, cover your head with a towel and slowly and deeply inhale the steam for about 5-10 min, depending on how long you can handle it, or the water stays hot. Otherwise, you can use your morning shower in a closed bathroom as your steaming session.

This will help moisturise the air passages and loosen sticky secretions.

Step 2 – Postural Drainage (getting gravity to help drain the phlegm)

The different lobes of the lung have its’ exits at different angles, so the section affected will determine the position. At home, however, you can use more one-size-fits-all positions. Lying on your tummy or side with some pillows under your hips will cause your head to be slightly lower and your lungs to angle with the lower section higher than the top. Gravity can now assist. For the upper lobes, the person can sit on a chair.

   

If you are a parent, you can use this technique on your child, toddler or baby. You can lie them over your lap or make them sit on your lap in different positions to get to all the lobes. Make sure you have a favourite toy handy or do the session in front of the TV where they are entertained and not paying so much attention to what you are doing.

Step 3 – Percussions and/or vibrations

This is where the fun starts. You will most likely not be able to do this by yourself unless you are a contortionist. You may have to ask your spouse/a partner to assist.

Precautions and contraindications for safe percussions

- Always check with your doctor or physiotherapist if it is safe to do chest physiotherapy treatments at home, as there are more technical precautions and contra-indications 

- Only do the percussions over the rib area, do not go over the tummy or lower back area

- Do not do percussions or vibrations if you suspect a broken rib or if the person has severe osteoporosis

- Be careful in front, over the breast tissue, as well as over the heart area if the person has a serious cardiac condition or has a pacemaker and/or defibrillator

- In small children, toddlers and babies, do chest physio using only one hand

- If the treatment hurts in any way, rather consult with your doctor or therapist again

Percussions are done with a cupped hand so that you can be quite vigorous with the treatment without hurting the person you are treating. Try and create the movement at your wrist while keeping your hands and arms rigid and your shoulders relaxed. This will be less tiring for you and more comfortable for the person receiving the chest treatment. Percussions ideally should be done for about 15-30 min. You can split the time between doing it while the person is lying on their tummy, left and right side, and sitting. 

   

An alternative to percussions is vibrations. You can do this at home with a manual hand massager that you move over the chest area of the person you are treating.

Home advice

Discuss breathing exercises with your physiotherapist. Be sure to do these as prescribed and as often as prescribed to maximise the effect of the chest physiotherapy sessions and get you back on track as soon as possible.

Remember, Physiotherapists are first-line practitioners. You do not need a referral from a doctor to consult a physio. 

My name is Monique de Beer and I am a registered physiotherapist and have my practice at the Timron Health and Wellness Centre in the Randburg and Greater Fourways area in Johannesburg, South Africa.

FEEL FREE TO CONTACT ME if you have any questions or would like to book an appointment

 Visit my Youtube Channel to see a video on "How to Alleviate Chest Congestion at Home"

 

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