Universidad de Zamboanga

SCHOOL OF ALLIED MEDICINE

RESPIRATORY THERAPY DEPARTMENT

Chest Physical Therapy

 CHEST PHYSICAL THERAPY
Chest physical therapy (CPT) is a variety of techniques aimed at the
mobilization of pulmonary secretions and promotion of greater use of
the respiratory muscles, which should result in an increase in the
distribution of ventilation.

UNIVERSIDAD DE ZAMBOANGA
 Goals of CPT
• To prevent the accumulation of pulmonary secretions
• To improve the mobilization of retained secretions
• To improve the distribution of ventilation
• To decrease airway resistance
How long does CPT take?
• Generally, each treatment session can last between 20 to 40 minutes.
• Early morning and bedtimes are usually recommended
• CPT is best done before meals or one-and-a-half to two hours after
eating, to decrease the chance of vomiting
 Techniques included in CPT
• Postural drainage
• Chest percussion
• Chest vibration
• Cough techniques
• Breathing exercises
 Indications for CPT
• Lung conditions that cause increased difficulty in mobilizing pulmonary
secretions
a. Bronchiectasis
b. Cystic fibrosis
• Acute respiratory failure with retained pulmonary secretions
• Acute atelectasis
• Ventilation and perfusion abnormalities resulting from retained pulmonary
secretions
• Inefficient breathing patterns in patients with COPD
• Prevention of postoperative respiratory complications
 Contraindications for CPT
• Recent spinal surgery or injury
• Head and neck injury (until stabilized)
• Active hemoptysis
• Empyema
• Rib fractures
• Pulmonary edema associated with congestive heart failure
• Large pleural effusions
• Osteoporosis
 Postural Drainage Positions
1. Posterior basal segment of the lower lobe of the lung.
2. Position to drain the lateral basal segment of the lower lobe of the lung.
3. Position to drain the superior segment of the lower lobe of the lung.
4. Position to drain the anterior basal segment of the lower lobe of the lung.
5. Position to drain the lateral and medial segments of the right middle lobe of the lung.
6. Position to drain the superior and inferior lingular segments of the left lung.
7. Position to drain the apical segment of the upper lobe of the lung
8. Position to drain the anterior segment of the upper lobe of the lung.
9. Posterior segment of the upper lobe of the lung.
Postural Drainage Positions
1. Position to drain the posterior basal
2. Position to drain the lateral basal segment
segment of the lower lobe of the lung of the lower lobe of the lung
Postural Drainage Positions
3. Position to drain the superior segment of 4. Position to drain the anterior basal
the lower lobe of the lung. segment of the lower lobe of the lung.
 Postural Drainage Positions
5. Position to drain the lateral and medial segments 6. Position to drain the superior and inferior
of the right middle lobe of the lung. lingular segments of the left lung.
 Postural Drainage Positions
7. Position to drain the apical segment of the upper 8. Position to drain the anterior segment of the
lobe of the lung upper lobe of the lung.
Postural Drainage Positions

9. Posterior segment of the upper lobe of the lung.

Areas should not perform CPT
• Spine
• Sternum
• Scapular
• Clavicle
 Areas of Trauma
• Burn
• Bare Skin
• Female Breast
• Aspiration
 Complication of CPT
• Hypoxemia
• Rib fractures
• Increased airway resistance
• Increased ICP
• Hemorrhage
• Decreased cardiac output
•THANK YOU!