THIS PPT IS MADE ONLY FOR LEARNING PURPOSE AND IT CAN BE WRITTEN AS PT MANAGEMENT FOR ANY PULMONARY DISEASE WHETHER OBSTRUCTIVE OR DESTRUCTIVE IN EXAMINATION. PROTOCOL VARIES FROM PATIENT TO PATIENT IN CLINICAL PRACTICE.

1. PULMONARY
DISEASE PT
MANAGEMENT
DR.SAMIR JADAV (PT)

2. DISEASES
ASTHMA
BRONCHIECTASIS
CYSTIC FIBROSIS
COPD
PNEUMONIA
PLEURISY
PLEURAL EFFUSION
PNEUMOTHORAX
EMPYEMA, etc.

3. PROBLEM LIST
Breathlessness
Cough
Sputum
Fatigue
Weakness
Wheeze/Crackle
Chest pain
Pyrexia, etc.

4. GOALS
1. Maximize the patients quality of life
2. Optimize/improve alveolar ventilation
3. Optimize lung volume, capacity and flow rate
4. Reduce work of breathing
5. Maximize aerobic capacity
6. Optimize respiratory muscle strength and endurance.

5. AIMS
1. To educate patient
2. To increase lung volume
3. To reduce work of breathing
4. To maintain bronchial hygiene or clear secretions
5. To improve chest mobility
6. To improve ADL
7. To reduce tightness
8. To improve posture
9. To gain full lung re-expansion
10.To regain ex. Tolerance and fitness
11.To reduce bronchospasm (if present)
12.To improve quality of life and general health.

6. MEANS
1) To educate patient
 Give necessary information about the condition and role of
physical therapy in treatment.
2) To increase lung volume
a) Body positioning
b) Controlled Mobilization

7. Patient takes small and rapid inhalation several times and
then exhale slowly.
Which helps to prolong the exhalation and slow the
respiratory rate and encourage some relaxation.
c) Breathing exercises
 Diaphragmatic breathing
 Glossopharyngeal breathing
 Pursed-lip
 Segmental
 PEP breathing
 End inspiratory hold
 Neurophysiological facilitation :- intercostal stretch
vertebral pressure

8. 3) To reduce work of breathing
a) Sleep and rest
b) Positioning
- Max. stay in side lying
- Standing position
- Sitting position upright in a chair with support
c) Relaxation techniques
- Relaxed sitting
- Forward lean sitting
- Relaxed standing
- Forward lean standing

9. 4)To maintain bronchial hygiene / clear secretions
a) ACBT with percussion .
b) Autogenic drainage.
c) postural drainage
d) Humidifications.
e) Breathing ex
f) Mechanical Aids.
- positive expiratory pressure
- flutter & Acapella
-Suction.
g)Coughing & Huffing.
h)Cough Assisted technique (Donna-pg373)
 Manually :- - Costophrenic assist tech.
- Abdominal thrust assist
- Anterior chest compression assist
- Counterrotation assist

10. Self-assisted technique
o Prone on elbow, head flexion self assisted cough
o Long sitting self assisted cough
o Short sitting self assisted cough
o Hands knee rocking self assisted cough
o Standing self assisted cough
5) To improve chest mobility
o Mobility ex.
o Thoracic expansion ex.

11. 6) To improve ADL
a) Ex. tolerance improve
- graded active ex. for the limbs and trunk.
b) Fitness improve
- Exercise circuit training
- Aerobic ex.
warm up phase : 3-5 mins
conditioning phase : 10-15 mins
cool down phase : 3-5 mins
7) To reduce tightness
gentle stretching : 30 sec hold, 3 repetition, 3 times per day

12. 8) To improve posture
 Mirror biofeedback
 Spinal orthosis
 Strengthening to weak muscles
 Stretching for tight muscles
9) Improve quality of life and general health
 Regular ex
 Prevention of complication
 Yoga
 Group therapy
 Relaxation techniques