Physiotherapy for chest after surgery in Delhi.
Chest physical therapy is a method of clearing the airway of excess mucus. It is based on the theory that when various areas of the chest and back are percussed, shock waves are transmitted through the chest wall, loosening the airway secretions. If the patient is positioned appropriately, the loosened secretions will then drain into the upper airways, where they can then be cleared using coughing and deep breathing techniques.
Turning
Turning from side to side permits lung expansion. The patient may turn on his or her own, or be turned by a caregiver. Turning should be done at a minimum of every two hours if the patient is bedridden. The head of the bed can also be elevated in order to promote drainage.
Coughing
Coughing helps to break up secretions in the lungs so that the mucus can be expectorated or suctioned out if necessary. Patients sit upright and inhale deeply through the nose. They then exhale in short puffs or coughs. This procedure is repeated several times a day.
Deep breathing
Deep breathing helps expand the lungs and forces an improved distribution of the air into all sections of the lungs. The patient either sits in a chair or sits upright in bed and inhales then pushes the abdomen out to force maximum amounts of air into the lung. The abdomen is then contracted, and the patient exhales. Deep breathing exercises are done several times each day for short periods.
Postural drainage
Postural drainage uses the force of gravity to assist in effectively draining secretions from the smaller airways into the central airway where they can either be coughed up or suctioned out.
Percussion
Percussion involves rhythmically striking the chest wall with cupped hands. It is also called cupping or clapping. The purpose of percussion is to break up thick secretions in the lungs so they can more easily be removed. Percussion is performed on each lung segment for one to two minutes at a time. Mechanical percussors are available and may be suitable for children over two years of age. The percussor is moved over one lobe of the lung for approximately five minutes, while the patient is encouraged to performing coughing and deep breathing techniques. This process is repeated until each segment of the lung is percussed.
Vibration
As with percussion, the purpose of vibration is to help break up lung secretions. Vibration can be either mechanical or manual. It is performed as the patient breathes deeply. When done manually, the person performing the vibration places his or her hands against the patient's chest and creates vibrations by quickly contracting and relaxing arm and shoulder muscles while the patient exhales. The procedure is repeated several times each day for about five exhalations.
Positive expiratory pressure (PEP)
PEP therapy has been extensively tested and is equivalent to standard chest physical therapy. It is an airway clearance method that is administered by applying a mechanical pressure device to the mouth. By breathing out with a moderate force through the resistance of the device, a positive pressure is created in the airways that helps to keep them open. This positive pressure permits airflow to reach beneath the areas of mucus obstruction and to move the mucus toward the larger airways where it can be expectorated.
Flutter
The flutter valve is a hand-held mucus clearance device designed to combine positive expiratory pressure (PEP) with high frequency airway oscillations. The device looks like a pipe containing an inner cone that cradles a steel ball sealed with a perforated cover. Exhalation through the device results in a vibration of the airway walls, which in turn loosens secretions.