The caregiver should not lean forward when doing percussion, but should remain in an upright position to protect his or her back. Keep a supply of tissues or a place to cough out the mucus nearby. The caregiver should remove rings and other bulky jewelry, such as watches or bracelets. Light, soft clothing, such as a T-shirt, may be worn. Before starting, the person should remove tight clothing, jewelry, buttons, and zippers around the neck, chest and waist. Doing CPT Comfortably and Carefullyīoth the person with CF and the caregiver should be comfortable during CPT. Your CF doctor or respiratory therapist can recommend what positions, how often and how long CPT should be done. The length of CPT and the number of times a day it is done may need to be increased if the person is more congested or getting sick. Early morning and bedtimes are usually recommended.

CPT is best done before meals or one-and-a-half to two hours after eating, to decrease the chance of vomiting. Generally, each treatment session can last between 20 to 40 minutes.

Your CF respiratory or physical therapist can help you learn more about this type of breathing. The belly moves outward when the person breathes in and sinks in when he or she breathes out. Breathing with the diaphragm (belly breathing or lower chest breathing) is used to help the person take deeper breaths and get the air into the lower lungs. Exhalation should be as slow and as complete as possible.ĭeep breathing moves the loosened mucus and may lead to coughing. Vibration is done with the flattened hand, not the cupped hand (see the figure below). (The caregiver may also place one hand over the other, then press the top and bottom hand into each other to vibrate.) Then, the caregiver applies a light pressure over the area being vibrated. The caregiver places a firm hand on the chest wall over the part of the lung being drained and tenses the muscles of the arm and shoulder to create a fine shaking motion. Vibration is a technique that gently shakes the mucus so it can move into the larger airways. Ask your CF doctor or respiratory therapist to recommend one that may work best for you. Lower ribs or back (to prevent injury to the spleen on the left, the liver on the right and the kidneys in the lower back)ĭifferent devices may be used in place of the traditional cupped palm method for percussion.Special attention must be taken to not clap over the: If the hand is cupped properly, percussion should not be painful or sting. Most of the movement is in the wrist with the arm relaxed, making percussion less tiring to do. Percussion is done forcefully and with a steady beat. The cupped hand curves to the chest wall and traps a cushion of air to soften the clapping. The hand is cupped as if to hold water but with the palm facing down (as shown in the figure below). The person is then encouraged to cough or huff forcefully to get the mucus out of the lungs.Ĭlapping (percussion) by the caregiver on the chest wall over the part of the lung to be drained helps move the mucus into the larger airways. This is usually done for three to five minutes and is sometimes followed by vibration over the same area for approximately 15 seconds (or during five exhalations). When the person with CF is in one of the positions, the caregiver can clap on the person’s chest wall. Your care team may tailor these positions to your or your child’s needs. That part of the lung is then drained using percussion, vibration, and gravity. With postural drainage, the person lies or sits in various positions so the part of the lung to be drained is as high as possible. It can also be done by physical therapists, respiratory therapists, or nurses during care center visits or in the hospital. For a child with cystic fibrosis, CPT can be done by anyone, including parents, siblings, and friends. This is where a caregiver or partner can clap and or vibrate the person’s chest to further dislodge and move the mucus to the larger airways where it can be coughed or huffed out of the body.ĬPT is easy to do. When combined with percussion, it may be known as postural drainage and percussion (PD&P). Each position is designed so that a major part of the lung is facing downward. With chest physical therapy (CPT), the person gets in different positions to use gravity to drain mucus (postural drainage) from the five lobes of the lungs.

Lung percussion sounds