Chest PT Methods

Hanine Hassan
BPT 7th Semester
162102008
 Percussion
• Percussion aids in the removal of secretions from the tracheal
bronchial tree.
• Percussion is done by cupping the hand so as to allow a
cushion of air to come between the percussor's hand and the
patient.
• There should be a towel between the patient and the
percussor's hand in order to prevent irritation of the skin.
• Percussion is applied over the surface landmarks of the
bronchial segments that are being drained.
• The hands rhythmically and alternately strike the chest wall.
• Incisions, skin grafts, and bony prominences should be
avoided during percussion.
 INDICATIONS
• Patients with pulmonary disease that are associated with
increased production or viscosity of mucus, such as chronic
bronchitis and cystic fibrosis.
• Patients who are on prolonged bed rest.
• Patients who have received general anesthesia and who have
painful incisions that restrict deep breathing and coughing
postoperatively.
• Any patient who is on ventilator if he or she is stable enough
to tolerate the treatment.
• Patients with acute or chronic lung disease, e.g. COPD.
• Patients who are generally weak or elderly.
• Patients with artificial airways.
CONTRAINDICATIONS
• Over fractures, spinal fusion, or osteoporotic bone.
• Over tumor area.
• If a patient has a pulmonary embolus.
• If a patient has a condition in which hemorrhage could easily
occur.
• If the patient has an unstable angina.
• If the patient has a chest wall pain.
• If patients has a hyper-reactive airways and severe
bronchospasm; though, not an absolute contraindication
 Vibration

• Vibration to the chest wall is the manual application of fine

oscillatory movements, of high frequency, with chest
compression timed with expiration.
• While vibration is being administered, the patient is instructed
to take slow deep breaths (thoracic expansion exercises) to
enhance the effect of airflow on the movement of secretions.
• The physiotherapist, or family member, places their hands on
the patients’ chest, either one hand on top of the other, or
side by side, depending on the size of the chest wall. As the
patient breathes out, a rapid oscillatory movement is applied
in the direction of the normal movement of the ribs and is
transmitted through the chest using body weight.
 Shaking
• More vigorous form of vibration applied during
exhalation.
• Intermittent bouncing manoeuvre and wide
movement of therapist hands.
• Fingers wrapped around the chest with thumbs
locked and placed directly on the patients chest.
• PT directly compresses and shakes the chest
wall.