What is Physiotherapy?
Chest physiotherapy, or physio (pronounced fizz-ee-oh) for short, is a term for a group of treatments designed to help remove mucus from the lungs and sinuses. The basic principle of chest physiotherapy is the same: mobilise that mucus and get it out of your lungs!
Why is Physiotherapy important?
If you have Primary Ciliary Dyskinesia (PCD), it is extremely important that you do daily physiotherapy to help remove the mucus from your lungs and sinuses. If you are suffering from an infection, you are likely to need to do more physiotherapy than usual.
Everyone with PCD has a slightly different physiotherapy routine which is based on their lifestyle and needs. You will have access to a specialist physiotherapist if you are under a PCD centre in the UK, and these physiotherapists will help and guide you to select the techniques that suit you or your child's needs.
Normally, mucus traps dust and bacteria in the lungs which is then swept out by cilia. In someone without PCD, the cilia in the lungs act like an escalator moving mucus up and out of the lungs where it can be coughed out or swallowed. However, in those with PCD, mucus stays in the lungs because the cilia do not work properly, which is why physiotherapy is vital to help remove mucus.
If the mucus, or sputum, is trapped in the lungs, it can cause infection and inflammation which leads to airway damage. This airway damage can also lead to more mucus getting stuck. Physiotherapy can help to break this cycle and prevent infections and irreversible lung damage.
Coughing alone is not enough to remove mucus in the lungs. Those with PCD need to help their lungs to remove this mucus using physiotherapy.
Physiotherapy can help to delay lung damage, reduce wheeze, reduce coughing, and can help to prevent infections and inflammation. I do hope we have managed to convince you the importance of physiotherapy!
Physiotherapy equipment and techniques
Your/your child's physiotherapy routine will be recommended to you by your physiotherapist. Be honest when you discuss your routine with your physiotherapist, as they will be able to give you many hints and tips to improve your physiotherapy experience. We have a dedicated page detailing some of the more common techniques and equipment here:
Physiotherapy Techniques and Equipment Dedicated Page (this link will open in a new tab/window)
Managing Your Child's Physiotherapy
We really appreciate how difficult it can be to encourage and support your child to complete their physiotherapy.
Our most valuable piece of advice is to use your child’s physiotherapist! If treatment is challenging, please reach out to your PCD team, they are there to support and help you.
Tips and Tricks
- Try to be consistent with what you expect from your child – this could be the time treatment is completed or that treatment always happens as part of a routine.
- Completing treatment as part of a routine will make it as automatic as possible – this could be as part of morning, after tea or as part of the bedtime routine.
- If your child feels that treatment is boring and their fed up that they must complete it – acknowledge their feelings.
- Try to have a greater focus on praise – balance the prompting or correcting of treatment with giving praise.
- Try to make treatment as enjoyable as possible.
- Try to incorporate an element of reward.
Managing Physiotherapy in Adulthood
It can be difficult to work out where to fit your treatments in when you have so many other commitments or when you don’t have much of a routine to your day. Sometimes our situations can change, and you may find that your current physiotherapy routine no longer suits you. All of these are understandable, but you must ensure you chat to your PCD physiotherapist about any changes as they will be able to support you.
If you are finding it difficult to manage your PCD treatments, speak to your PCD team. They are not going to tell you off for missing your physio or not exercising but will be glad that you’ve recognised that it is getting tricky, and you need a bit more help.
Here are some tips that may also help:
- Getting into a routine with your treatments. It will make it easier to remember to do them. For example, you could plan to do your nebs every morning as soon as you wake up or every evening when you get in from work/college. It doesn’t matter what routine you decide on, but it must be one that works for you and your lifestyle.
- Set small goals. If you are currently doing no physio, it will be hard to suddenly start doing it twice a day, every day. So set yourself a more realistic goal. What do you think you could achieve in the short term?
- Plan ahead – when are you going to do your physio, what will you do if something else crops up? Could you plan to do it at a different time as a back-up?
- Put things in your sight (literally). If you put your physio device, your nebuliser or your running shoes somewhere where you are likely to see them, it will prompt you that you were planning to do your physio/take your nebs/go for a run.
- Be honest with yourself. What gets in the way of you exercising, doing your nebs, doing your physio? Chat to your physio about the difficulties you are having. They may be able to suggest an alternative to your current treatment plan or help you to overcome your barriers. If they don’t know that you are struggling, they won’t know that you need help!
Your Physiotherapist Appointment
A specialist physiotherapist will review you at clinic appointments, including at your annual review at the specialist centre.
The annual review is an extensive assessment at your specialist centre by the multi-disciplinary team including specialist respiratory doctor, specialist ENT doctor, PCD nurse, PCD physiotherapist, dietician and psychologist if required.
To make the most of your physiotherapy appointment, usually you will need to bring the following with you: -
- Physio equipment: any devices you use e.g. Aerobika and your nebuliser for service.
- Spirometer if you have one (see our Spirometry Page for more information)
- List of medications.
Be aware of your baseline symptoms and be prepared to explain how you have been. Has your cough changed? Are you coughing more frequently? Has your sputum changed in quantity, colour or thickness? Has your life changed so that your physio needs to fit around it in a different way? If you are attending with your child, it may be useful to bring a snack/packed lunch/drink and something to keep them entertained.
During your appointments the physiotherapist will review and refine your airway clearance technique using your devices.
The physiotherapist may also make assessments in relation to exercise, sinuses/nose, pelvic health, sleep, and musculoskeletal issues.
It is important to be honest with your physiotherapist so that you can be supported in the best way possible, especially if you are finding that completing the treatment at home is a challenge. The physiotherapists are there to help, support and find the right treatment for you. It is normal to change your routines at times.
Follow-ups
Each patient is assessed at the annual review and follow up appointments are dependent upon this. Sometimes your follow up appointments may need to be more regular for a while, which is not uncommon. Appointments may be offered as face to face, virtual, or on the telephone/online video call.
Physiotherapists recognise that sometimes support may be required outside clinic. This may be when you are unwell, need support to make changes to your physiotherapy routine, or need support when you are finding treatment a challenge. At times support can be offered to people involved in your or your child’s care, like your child’s nursery or school.
Physiotherapy Glossary
We know that sometime information given by your PCD teams can include lots of new words you may not have heard before. We've put together this handy glossary to help you better understand this information.