COPD Breathing Techniques

Respiratory Care

• Adults have more bronchial wall instability, making them more prone to collapse.
• People with Chronic Obstructive Pulmonary Disease (COPD) have more collapsible airways.
• Repeated coughing can cause fatigue and discomfort, so it's essential to save coughing for the final secretion evacuation phase.
• Removing excess secretions (phlegm) from the lungs can help improve lung function.

Autogenic Drainage

• Autogenic drainage is a system of breathing exercises developed in 1967 to move secretions from peripheral to central airways.
• The technique uses controlled breathing to maximize expiratory flow with minimal airway closure.
• There are three phases of the breathing exercise:
  • "Unsticking" mucus in smaller airways by breathing in the base of the lungs.
  • "Collecting" mucus in middle airways by breathing at low to mid-lung levels.
  • "Evacuating" mucus from central airways by breathing at mid to high lung levels.

Breathing Exercises

• Level One: "Unsticking" of mucus by low lung level breathing.
• Level Two: "Collecting" the mucus in larger or mid-sized airways.
• Level Three: "Evacuating" the mucus in central airways by breathing at normal to high volumes.
• The full cycle takes 6-9 minutes.
• Coughing should be avoided if possible in levels I and II.

Percussion and Vibration

• Percussion is a technique used to help loosen secretions in the lungs.
• Rhythmic clapping on the patient's chest with cupped hands or soft-rimmed face mask is a common method.
• Contraindications include over rib fracture, direct surgical incision or graft, frank haemoptysis, severe osteoporosis, and severe clotting disorder.

Assisted Cough

• Assisted cough is a technique used to help patients with spinal cord injury or neuromuscular disease cough effectively.
• The physiotherapist provides manual upwards compression of the diaphragm to replace the work of the abdominals.
• This helps facilitate a cough in patients with respiratory difficulties.

Mucociliary Clearance

• Particles that escape filtration in the nose are trapped on a sticky mucus blanket lining the airways.
• Cilia beat synchronously to propel the mucoid secretions to the pharynx and larynx, where they are swallowed or expectorated.
• Secretions are propelled at speeds of between 0.5 mm/min in small airways and 20 mm/min in the trachea.
• Impaired mucociliary clearance predisposes to infection.

Postural Drainage

• Postural drainage is a technique used to facilitate the drainage of secretions from the bronchial airways.
• Different positions are assumed to use gravity to move secretions to the trachea, making them easier to cough up.
• The goal of postural drainage and manual therapy is to help drain mucus from each of the lobes into the larger airways of the lungs.

Indications and Contraindications

• Indications for respiratory physiotherapy include sputum retention and exacerbation of bronchitis.
• Contraindications include hypertension, severe dyspnoea, recent surgery, severe haemoptysis, nose bleeds, advanced pregnancy, hiatus hernia, cardiac failure, cerebral oedema, aortic aneurysm, head or neck trauma/surgery, and mechanical ventilation.

Inspiratory Muscle Trainer

• An inspiratory muscle trainer is a device that allows patients to perform sustained maximal inspiration (SMI) while providing visual quantitation of the inspiratory effort.
• The device helps increase the transpulmonary pressure gradient, which can help prevent or treat atelectasis.
• It is commonly used in surgical patients to reduce postoperative complications by increasing inspiratory capacity.

Learn effective breathing techniques for individuals with Chronic Obstructive Pulmonary Disease (COPD). Discover how to manage symptoms and improve lung function.