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The challenges for effective physiotherapy are adapting and tailoring techniques to age and circumstances e.g. transition experiences, adapting to work, relationships, pregnancy etc.
Posture is very important, and research shows that impaired posture can impair lung function.
Evidence also suggests that exercise is almost as effective as puffers. Trampolines are particularly effective. Activity is really important, and sport should be encouraged. It can be helpful to use a flutter before football.
There are various aids to loosen mucus, thereby making it easier to cough it up. These are mucolytics and include hypertonic saline (i.e. salty water) which can be inhaled by nebuliser. This is not suitable for everyone, and the airways need to be checked for toleration. There is also Mucodyne and Dnase medication.
In order of efficiency, the most efficient ways to clear the airways:
- Open airways (using inhalers)
- Use Mucolytics
- Airway clearance
- Steroid inhaler
- Inhaled antibiotics
The following questions should be asked so that the patient knows they are doing what is right for them and what works for them:
- Is my physiotherapy effective?
- Is my condition stable?
- Do my physiotherapy techniques fit with my life style?
Each patient should ask for a physio review periodically.
The British Lung Foundation has useful information about Pulmonary Rehabilitation for adults with PCD/Bronchiectasis