Respiratory physiotherapists assist patients with problems affecting your lungs.

 

These difficulties may be as a result of long standing disease, e.g. asthma, chronic obstructive pulmonary disease (COPD), bronchiecatsis;  Or as a result of a dysfunctional breathing patterm; Or after an acute illness requiring surgery or a stay in hospital.

Respiratory physiotherapy can help with symptoms such as:

  • Excessive secretions
    • Breathlessness at rest or on exertion
    • Reduced exercise ability or function due to shortness of breath.

At an initial session  the physiotherapist will complete a thorough assessment to identify your main problems. Following this an individualised treatment programme will be devised.

Here at Hallamshire Physiotehrapy we can provide services for:

  • Airway clearance techniques
  • Pulmonary rehabilitation courses
  • Dysfunctional breathing patterns / Vocal cord dysfunction / hyperventilation syndrome
  • Bronchiectasis advice and management
  • COPD advice and management
  • Breathless management

Please refer to the separate tabs for more information on each service.  If you are unsure at all please contact the clinic where we will be able to advise you.  Treatments are carried out at the clinic.  However, if you have difficulty leaving your house we can discuss home visits.

Pulmonary Rehabilitation

Pulmonary rehabilitation (PR) is an evidence based programme of physical activity and education for people living with chronic lung disease. The research shows that PR can:

Help you feel less breathless

Increase the distance you can walk before stopping

Reduce the number of flare ups (exacerbations) you have

Reduce the chance of a hospital admission with breathlessness

Increase mental wellbeing

Increase quality of life

Improve your self-management and knowledge of your condition

(British Thoracic Society PR guidelines, Thorax, 2013)

PR is considered an essential component of treatment in the management of Chronic Obstructive Lung Disease (COPD)alongside giving up smoking, having the seasonal flu and pneumococcal vaccine and using inhalers (NICE 2010& GOLD report 2018). It can also have similar effects in other chronic lung disease such as bronchiectasis, interstitial lung diseasesand difficult asthma.

Here at the Hallamshire Physiotherapy we can offer individual or small group sessions of pulmonary rehabilitation following an initial 1:1 assessment of your needs. The evidence shows that the best outcome is after a programme of 2 sessions for 6 weeks. We can then help you maintain your activity levels by signposting you to local groups that best suit you.As well as for people who have had surgery for lung cancer.

We will of course discuss your individual needs in the initial assessment.

 

Airway clearance / chest physiotherapy / sputum or mucus clearance

Physiotherapy has been shown to be successful in the facilitation of clearing the lung airways of sputum, whether caused by:  an acute episode of chest infection or pneumonia; chronic lung disease such as bronchiectasis or cystic fibrosis.

In the initial assessment sessions the Physiotherapist can assess your lungs by taking a history, listening to your chest and using other observations. They then can teach you the most suitable method(s) for you to clear sputum.

This can usually be through breathing techniques but can also be done using “adjuncts” or small pieces of equipment to facilitate the process.

 

( BTS/ACPRC Guidelines for physiotherapy management of the adult, medical, spontaneously breathingpatient. Thorax 2009)

Bronchiectasis

What is it?

Bronchiectasis is a respiratory condition that is characterised by widened bronchi (tubes) in your lungs.  There is also an increased production of mucous which can be difficult to clear. This build up of mucous can make you more susceptible to chest infections.  Recurrent infections may cause a progression of the disease.

In some cases there is no known cause for the development for bronchiectasis.   However it can be linked to previous recurrent infections, prolonged infections, poor immune system, poorly controlled reflux.

The symptoms of bronchiectasis can include:

  • Mucous production
  • Cough
  • Recurrent chest infections
  • Some shortness of breath
  • Reduced exercise ability

 

The diagnosis of bronchiectasis is made with a HRCT scan.

 

Treatment

Bronchiectasis is not curable.  The main treatment is to manage the clearance of secretions to prevent the build up and further infections.  This can be done by physiotherapy techniques.  In some cases medications may help such as saline nebuisers or anti mucolytics.  Antibiotics are necessary when there is a bacteria present in your lungs.

The physiotherapy treatment techniques can include:

  • Education and advice about the condition
  • Breathing exercises to clear mucous
  • Postural drainage.
  • Adjuncts such as flutter / acepella / pep
  • Manual therapy
  • Exercise advice
  • Breathless management
  • Exercise regime such as pulmonary rehabilitation

 

A typical course of therapy is 2 – 3 sessions.  The physiotherapist will teach you ways to best manage your condition yourself or with the help of your family so that you do not need to see physiotherapy regularly.

If your exercise tolerance is affected then pulmonary rehabilitation may be beneficial which a course over 6 weeks.

Dysfunctional breathing Patterns

What is it?

When we breath it should be:   Relaxed

From your lower lungs

Without needing to think about it. (Subconscious effort)

However sometimes our breathing pattern can alter.  This can be as a result of stress, pain, underlying lung disease or infections. When our breathing pattern is altered we no longer breath as effectively.   This can then cause symptoms such as:

  • Breathless ness after light exertion
  • Unable to take a big breath in
  • Chest and thoracic pain
  • Stomach cramps
  • Palpitations
  • Frequent yawning / sighing / throat clearing

 

The diagnosis of dysfunctional breathing is made following a CPET test.   Or based on the results of previous lung function tests alongside a detailed history.

The main treatment for dysfunctional breathing is physiotherapy to correct your pattern. If left untreated,the condition risks becoming a chronic problem and symptoms may worsen.

 

Treatment

After a thorough assessment a treatment program is devised tailored to your individual problems. This programme may include:

  • Education and advice regarding your possible trigger
  • Education and advice regarding your pattern of breathing.
  • Breathing control techniques
  • Breathing control when exercising
  • Breathing control when talking
  • Mechanical work to address any stiffness or pain
  • Relaxation

 

A typical course of therapy is between 4 – 6 sessions.   However, this can vary depending on the individual.

Contact Su Symonds, Cardiorespiratory physiotherapist for advice or an assessment.