Respiratory Physio

Why might my child/ young person need respiratory physiotherapy?

A respiratory physiotherapist helps look after the lungs. It is normal for all of us to produce secretions (sometimes called phlegm or mucus) from our lungs.  Normally secretions are loosened when we move around and breathe, and we get rid of them by coughing and clearing our throats.  This can be more difficult for a child/young person (CYP) when they are unwell, tired, weak, and not moving around. It is then harder for them to cough and clear their secretions. This makes it difficult for the lungs to work properly and so they become more at risk of getting a chest infection.  Respiratory physiotherapy helps your child to clear these secretions, to keep the lungs as healthy as possible.

Who may benefit from a respiratory physiotherapy assessment and treatment?

There are many groups of children who will benefit from specific respiratory physiotherapy input. This may include children who have the following conditions:

• Chronic lung disease. NB: Do not see cystic fibrosis or asthma
• Long term ventilation.
• Upper airway obstruction.
• Poor swallow, reflux and/or excessive oral secretions.
• Neuromuscular eg muscular dystrophies.
• Non-specific neurological eg complex cerebral palsy.
• Traumatic or acquired brain injury.
• Spinal cord injury that affects their ability to take a deep breath or cough.
• Chronic cardiopulmonary disorders.
• Skeletal deformities e.g. kyphoscoliosis, thoracic wall deformities.

Where and how often will a respiratory physiotherapist see CYP?

Once child has been referred, a respiratory physiotherapist will do an assessment, and treatment will be carried out depending on the needs of the CYP.

The CYP may be seen in a variety of settings i.e. at home, clinic, school/nursery or respite centre. Other professionals such as children’s community nurse, physiotherapist or speech and language therapist may also attend the visit to ensure holistic approach to the CYP care and treatment.

Respiratory physiotherapy will stop once your child is getting better, able to cough and clear secretions and move around as they do normally.

Physiotherapists usually work between the hours of 8.30am and 4.30pm.

What might respiratory physiotherapy treatment involve?

There several different techniques used to help clear secretions and keep the lungs full of air and as healthy as possible. The physiotherapist will work closely with family, carers and other professionals to ensure the treatment program is specific to meet the CYP needs and their current goals. Physiotherapy treatment may involve:

• Assessment and development of child specific treatment plans and teaching packages.
• Airway clearance assessment and treatment such as:
  • Positioning – a respiratory physiotherapist may help your child to sit or lie in different positions.  This can help the lungs to work better and may help to encourage typical movement and development.
  • Hands-on techniques – respiratory physiotherapists may use their hands on your child’s chest.  These include techniques called vibrations, shakes and percussion. They can help to help loosen secretions.
  • Breathing exercises.
  • Blowing games.
  • Respiratory equipment such as cough assist (mechanical insufflation-exsufflation), Vest (high frequency chest wall oscillation), suction machine, positive pressure devices eg PEP, acapella.
• Exercise therapy: Mobilising (rolling, sitting up, walking) will help to loosen secretions which may help CYP to cough and clear their chest. Exercise encourages CYP to develop strong muscles and bones, will help in the clearance of any secretions. It is good for CYP to do something every day for example trampolining, bouncing on a gym ball or space hopper, running, cycling, swimming.
• Inhalation therapy such as inhalers or nebulisers
• Postural care advice.
• Support and advice on adherence with treatment.
• Education, training and preventative management for CYP, parents and carers.
• Program for nursery/school or advice around activities within PE lessons.