Physiotherapy in respiratory disease

Key points

• Physiotherapy enhances airway clearance in respiratory diseases associated with hypersecretion.

• Forced expiratory techniques are the most important treatment modalities to improve short-term airway clearance.

• Respiratory muscle training enhances strength, endurance and symptoms in various conditions associated with respiratory muscle weakness.

• Exercise training and peripheral muscle training are effective components in the rehabilitation of patients with respiratory disease.

Educational aims

• To motivate the interest of chest physicians in physiotherapy.

• To provide a conceptual framework of physiotherapy in a variety of respiratory conditions.

• To provide details about efficacy of physiotherapy in respiratory conditions.

Summary Physiotherapy is relevant to the treatment of patients with acute and chronic lung disease, but it is also effective in patients with advanced neuromuscular disorders, in patients admitted for major surgery and patients with critical illness in the intensive care unit (ICU). Physiotherapy contributes to the assessment and treatment of various aspects of respiratory disorders, such as airflow obstruction, atelectasis, mucus retention, respiratory and peripheral muscle weakness, impaired exercise performance, dyspnoea, and quality of life. This overview discusses the contribution of physiotherapy in three conditions related to respiratory disease: deconditioning; dyspnoea and respiratory pump dysfunction; and impaired airway clearance and lung inflation.