But if you start down low and gently squeeze while working your way up to the top, you’ll get much more toothpaste out. If you squeeze just below the opening, you’ll get a tiny bit of toothpaste out. Unlike coughing, huffing doesn’t collapse airways, but rather provides a gentle squeezing to move the mucus up. An individual breathes out forcefully, pushing mucus from deep in the lungs into larger airways, where it can then be coughed out. Huffing is a forced expiratory technique that allows mucus to move up through the airways. The Acapella® is great for kids starting PEP therapy. The Acapella® can be used in any position and can be combined with postural drainage positions. It comes in two different levels of PEP (blue for younger children and green for older children and adults), each adjustable. This oscillating device provides pressure to shake secretions from the lung walls. Each treatment should be done twice a day for 15-20 minutes. There are many different forms of PEP therapy including: Acapella®, Flutter®, TheraPEP®, and Bubble PEP®, are some. This pressure keeps the small airways of the lungs open to improve the mobility of the secretions. Positive Expiratory Pressure (PEP) therapy is done by breathing through a device that provides resistance while exhaling. Creating a vibration force in adults is done using one or two hands to vibrate over specific lung segments. Using a trampoline, tumbling, performing wheel barrow races, and tickling are good ways to achieve this with older children. In infants, this force can be created by using “Tickle Me” toys, a bouncy seat with vibration, or bouncing the baby on your knee. Vibrationīy using their hands or manual devices on the chest, caregivers can vibrate or shake secretions from lung walls, allowing the person with CF to clear them by coughing. For older children and adults, CPT is performed using the whole hand, even doing both sides simultaneously, for a session lasting 25-30 minutes. Percussion is typically performed for approximately 2-5 minutes in each position. For infants, the percussion is made with 2-3 fingers, a bottle nipple, or a percussor cup. Using cupped hands, or a manual device, caregivers create a hollow clapping sound to loosen lung secretions. People with gastroesophageal reflux disease should avoid any head-down positions, as it may increase reflux. Older children can tolerate all of the positions that an adult performs. Positions are limited for infants, keeping them upright or side-lying because they tend to spit up. This technique uses a series of gravity dependent positions to drain mucus from the lungs. Download a brochure on chest physical therapy. You turn the bottle over (postural drainage), hit the side of the bottle to loosen the ketchup (percussion), and then shake the bottle to allow the ketchup to flow out of the bottle (vibration). The goal of CPT is like getting ketchup out of a ketchup bottle. It is a passive form of treatment for the person with CF and an active one for the caregiver. Airway clearance Chest Physical Therapy (CPT)Ĭhest physical therapy (CPT) consists of three components:Ĭhest physical therapy is started in infancy and can be used at any age.
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