People suffering from pneumonia, postoperative partial or complete collapse of the lungs, chronic respiratory conditions like Chronic Obstructive Pulmonary Disease, Cystic Fibrosis etc as well as people suffering from neuromuscular diseases can get partial relief by respiratory physiotherapy. If a person is suffering from retained secretions, increased effort to breathe or volume loss, he or she may be referred to Respiratory Physiotherapy.

Respiratory Assessment Of The Patient

A Respiratory Physiotherapist will assess the condition of the patient with the help of Respiratory Assessment or Respiratory Examination. It includes:

Auscultation and review chest X-Ray

Interpreting arterial blood gasses test and blood tests

History of present illness

History of past illnesses

Details of cough, breathlessness, sputum, chest pain  

Other symptoms like headache, fever, CO2 retention, heart failure, peripheral oedema, shivering, palpitations, weight loss, Gastrointestinal Reflux Disease, vomiting and nausea etc.

Respiratory Physiotherapy Techniques -

After the Respiratory Assessment the doctor may prescribe the following:

Breathing Exercises

Exercises like Active Cycle Of Breathing Techniques can help in clearing phlegm. Since people in respiratory distress often produce more phlegm than normal, it is essential that this excess phlegm be removed. This can help the person breathe more freely. Removing the phlegm can also help prevent infections in the chest and reduce coughing. It is a set of exercises that together help in establishing breathing control, huffing and deep breathing.

Mobilisation

Early mobilization is one of the most important aspects of chest physiotherapy. It includes positioning, active and passive turning, cycling pedals, standing, stepping etc. 

Manual Techniques

The Physiotherapist may apply pressure on the chest to facilitate airway clearance while keeping the patient in gravity assisted phlegm drainage position. 

IPPB

It employs a device that helps patients take a deep breath, cough and clear lungs. The device offers short-term and intermittent mechanical ventilation of a positive pressure set by a physiotherapist. The device pushes a mixture of oxygen through a facemask.

Suction

Here too the physiotherapist uses a device to suck out excess mucus from the chest and facilitate breathing. Here the cough is stimulated by a catheter and phlegm is sucked out using another catheter.

MHI

It is the acronym for Manual Hyperinflation. This procedure is carried out by a Respiratory Physiotherapist to give volume to partially or completely collapsed lungs.

BiPAP or CPAP

The device delivers pressurized air into the patient's airways through a facemask. The pressure of air prevents collapse of the throat muscles and reduces airway obstructions. In essence, they allow patients to breathe more freely and regularly. 

Conclusion

Right Respiratory Assessment or Respiratory Examination is crucial to applying the right physiotherapy techniques. Right techniques may help patients breathe more freely and avoid respiratory infections. 

Know More About Respiratory Examination!

Pulmonary Embolism is a blood clot in the Pulmonary arteries that usually travels from a deep vein in the legs to the lungs. This clot blocks the lungs and creates a life-threatening situation for the patient. With prompt medication and treatment, the risk can be mitigated. 

Symptoms 

The symptoms of Pulmonary Embolism vary with the size and position of the clot. The most common symptoms include pain in the chest and shortness of breath. The patient with Pulmonary Embolism suffers from chest pain occasionally, and it gets worse with physical activity. The pain is deep and feels like a heart attack.

The other common symptoms are: 

  Pain in legs or swelling 

  Fever 

  Irregular heartbeat 

  Fatigue 

  Feeling tired all the time 

  Coughing 

  Dizziness 

  Heartburn 

Causes 

Pulmonary Embolism is caused due to the formation of several clumps or blood clots that enter into the Pulmonary arteries. Typically, these clots are formed from the deep veins of the legs, also known as Deep Vein Thrombosis. The clots block the flow of blood in the lungs, which is fatal to the patients.

These clots gradually build up in the arteries. Some very common causes for the formation of these clots are the release of fats from the broken long bones, the tissue in the bloodstream or air bubble. 

Diagnosis 

The diagnosis of Pulmonary Embolism is difficult in patients who are already suffering from heart or lung conditions. However, doctors look for a D-dimer level in the bloodstream to determine the clots. There are various causes for a high level of D dimer, but it gives a starting point to the doctor to investigate further. 

  Blood Test: The blood test checks the level of D dimer in the blood. If the level is high, the doctor may determine the amount of oxygen level in the blood. Generally, the blood clots lower the level of oxygen in the blood. If the oxygen level is low, doctors doubt the presence of blood clots. 

  Ultrasound: The body imaging method helps doctors to check for clots in the blood without performing any operation. This non-invasive way gives the imagery of the veins. Clumps can easily be seen in the images of the Ultrasound report. 

  CT Scan: The spiral CT scan moves around the body to look for clots in the veins. It is a high-tech method through which doctors determined the number, size, and amount of blood clots in the patients. 

Takeaway 

The treatment for Pulmonary Embolism depends upon the size and number of clots in the body. If a person is already suffering from heart or lungs condition, then he/she shall be given medication accordingly. The most common treatment entails medicines, such as blood thinners, which makes the blood thinner. These medications help in dissolving the clots.

Pulmonary Embolism - How To Detect It?

The lungs are highly prone to chronic problems. Be it asthma, bronchitis or COPD, these problems require chronic treatment and the patient is always on alert. Homeopathy believes that these are just symptoms of an underlying, deep-rooted cause and addressing the root cause can help in complete cure of symptoms. By working on the underlying problem, homeopathy attempts to:

Prevent further damage to the organs; so disease progression is arrested
Reduce dependency on steroids and bronchodilators, which is very common among most people with chronic respiratory disorders
Natural and holistic treatment with minimal side effects
It is to be noted that different clinical presentations are treated with different compounds, and there are more than 25 compounds that can be used in people with chronic respiratory disorders. The doctor would choose the right compound depending on the presenting symptoms. Some of the commonly used compounds are listed below:

Bryonia: In people with dry hacking cough and rusty sputum, this is useful. The symptoms are aggravated by any sort of motion and warm temperatures.
Rumex: In people with dry/stringy cough, which is increased in cold temperatures and by talking, this medicine proves useful.
Kali Bichromicum: Where the patient has yellow, sticky mucous which is worse in the morning, this compound is effective.
Aconite: It is very useful in treating bronchitis, where there is frequent sneezing, restlessness, coryza-like symptoms or excessive perspiration. Its uniqueness is that it prevents development of a full-fledged bronchitis.
Belladonna: This is useful in patients with bronchitis who have violent fever and distressing cough that is worse with lying down and at night. The coughing spells are dry and short with irregular breathing. There is also fullness in the chest with no pain, though children might cry with this fullness. There is increased drowsiness where patients sometimes doze off into a semiconscious state.
Sulphur: It is very useful in people with chronic bronchitis, where the patient has significant rales (sounds due to air movement within the bronchi). This is accompanied by mucous that is thick and can contain pus. The patient could also suffer from bouts of suffocation.
Bacillinum: It is widely used in people who tend to catch cold easily. The mucous membranes are highly irritated and the patient feels very congested.
Other useful compounds include Phosphorus, Mercurius, Antimonium tartaricum, Rumex, Puslatilla, Ipea, Chelidonium and Sulphur. As noted, with homeopathic compounds, the right compound is determined by multiple factors including the stage at which the infection is at the time of presentation, nature of the cough, type of mucus, aggravating or relieving factors, presence of a cold, overall health status, habits, etc. The doctor will identify the right compound for you after checking these, so you are advised not to self medicate.

How To Treat Chronic Respiratory Problems With Homeopathy?

Over the last couple of decades, most chronic diseases are being treated by modes other than just medications. Physiotherapy is one such approach, and the success rate has been quite high.

The lungs are extremely vital organs in that they supply oxygen to the entire body, which in turn ensures optimal body functioning. When the ability of the lungs to perform is reduced, which happens in chronic lung diseases, then each organ in the body is affected. Therefore, the lung s ability should be restored so oxygen supply to all organs is improved.

Symptoms of chronic lung disease:

Shortness of breath, with even minimal exertion
Reduced exercise tolerance
Tightness and fullness in the chest
Excessive mucus secretion in the lungs
Wheezing
Smoking is one of the main causes with pollution, dust, ageing, etc. also contributing to reduced lung function.

Physiotherapy aims to improve lung function by a combination of measures

Improve breathing techniques
Improve posture
Improve mucus secretion
Improve lung capacity
The patient is taught various techniques which help in both chronic cases and in acute exacerbations.

Posture: In most chronic lung diseases, the patient assumes a stooped posture with bent shoulders. This reduces the capacity of the upper lungs. The patient is made to consciously keep the shoulders upright and arms extended so that the upper lungs are available for breathing. Shoulder, neck, and thorax movements are practiced so that each breathing cycle provides greater ventilation and improves oxygen supply to the body.
Breathing: The patient is taught to breathe with full force on the diaphragm. This makes the lower chest movements effective and improves ventilation in those areas. The patient is also taught pursed-lip breathing, where forceful expiration is practiced. This again improves lung efficiency. This practice of coordinated breathing helps.
Posture drainage: With a combination of clapping and shaking, the patient is taught to work on the affected lung areas. This allows for removal of mucus from the lungs, thereby improving lung capacity. The patient may sometimes be required to induce coughing to clear secretions.
Overall exercise: Though chronic lung diseases reduce overall ability to exercise, the key is to maintain an active lifestyle and practice a regular workout regimen. This ensures ventilation and circulation are maintained at optimal levels. It would be a vicious cycle if a person stops regular exercise due to chronic lung diseases.
Lifestyle changes: In addition to the above physiotherapy, the patient also should quit smoking, reduce exposure to dust and pollution, and use a protective mask when possible. Eating healthy and getting adequate sleep is also essential in the long run.

Role Of Physiotherapy In The Management Of Chronic Lung Diseases!

Lung diseases are some of the most common diseases suffered by human beings throughout the world. Smoking and infections are responsible for most lung diseases. The lungs perform one of the most important functions of the body. It is also one of the most active organs in the human body and hence lung problems can arise due to problems in any other part of the body. Some of the most common and infectious lung diseases are discussed below.

1. Asthma
Asthma is a common long term disease which is characterized by reversible airflow obstruction and bronchospasm. The symptoms of asthma include coughing, shortness of breath and tightness of chest. These symptoms may occur frequently during a day and depending on the person, it may become worse during night or during a certain exercise.

2. Pneumonia
Pneumonia is another common lung problem which is suffered due to inflammation in the microscopic air sacs in the lungs known as alveoli. Symptoms of pneumonia include dry cough, chest pain, breathing problem and fever. Pneumonia is caused most commonly by viruses or bacteria. It is also caused by certain medications and conditions which are popularly known as autoimmune diseases. There are a number of vaccines available to prevent certain types of pneumonia. Other methods include hand washing and refraining from smoking.

3. Tuberculosis
Tuberculosis is a very infectious disease which is caused by the bacteria mycobacterium tuberculosis. Although tuberculosis generally affects the lungs, but it has been known to affect other parts of the body as well. Symptoms of tuberculosis include cough containing sputum with blood, night sweats, fever and weight loss. Air is an active medium for spreading tuberculosis. This happens when people who already have tuberculosis sneeze, cough or speak. Infection occurs more in those who have hiv/aids or those who smoke. Prevention of tuberculosis includes staying away and keeping those who are at high risk, early detection and treatment and vaccination.

4. Mesothelioma
Mesothelioma is a type of cancer which affects the lungs. It affects the lining of the lungs and chest wall. Symptoms of mesothelioma include shortness of breath, swollen abdomen, cough, chest pain, weight loss and general lethargy. Mesothelioma is caused mainly due to exposure to asbestos. Those people who mine asbestos, produce products from asbestos, work with asbestos products are at high risk. Mesothelioma also results from genetical problems and due to infection caused by the simian virus 40.

5. Pulmonary embolism
This is a disease caused due to blockage of an artery in the lungs by a substance which has travelled from another part of the body by the bloodstream. Symptoms of this disease include chest pain, breath shortness and coughing up of blood. There may also be signs of blood clot in the legs.

Types of Lung Diseases

Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

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