The COVID-19 pandemic has caused short-term and long-term major dysfunctions.
In the respiratory system that require the application of special techniques.
In these cases, respiratory physiotherapy is an ally that improves the function of the muscles to breathe.
We will show below what it is about and what its benefits are.
What is respiratory physiotherapy?
It is a specialty within physiotherapy aimed at prevention, treatment and stabilization of respiratory disorders such as asthma, cystic fibrosis, respiratory insuffiency, bronchitis, or tuberculosis.
Its application improves, among other things, ventilation in the lung area, dyspnea, gasses exchange, muscle function, and tolerance to exercise.
Respiratory physiotherapy is made up of a set of procedures that allow to diagnose different conditions to then perform therapeutic techniques that release the airways.
They also promote respiratory relaxation and readjust effort in each patient.
These procedures can be done at home, a clinic or hospital, even when the patient is intubated, but they should always be done by a professional physiotherapist.
At present, we can say that respiratory physiotherapy improves dyspnea significantly, exercise capacity, and quality of life related to health.
As the main objective is to eliminate secretions (accumulated mucus), obstructions that make breathing difficult, are avoided to decrease the possibility of lung infections.
Among its benefits we have:
1. It reduces dyspnea (feeling short of breath) immediately as well as respiratory distress.
2. It keeps the airways open and free of secretions, in addition to avoid the accumulation of mucus in the lungs.
3. It improves lung expansion and elasticity, preventing injuries.
4. It helps control coughing.
5. It increases the strength of the respiratory muscles.
6. It recovers the ideal breathing and the model of correct breathing is learnt.
7. It reduces the time of hospital stay.
8. It improves gasses exchange and it facilitates oxygen to reach all the cells of the body.
9. It prevents postural defects.
10. It improves the quality of life of the person by providing a better night rest. Also, it reduces the disease process, it decreases the need for medications and it teaches the patient to keep calm.
As we can see, physiotherapy improves the supply of oxygen to the whole body, by releasing it from the secretions produced in the respiratory airways.
Next, we will name other benefits considering some specific areas where it can be used.
Respiratory physiotherapy can be applied to babies and children as long as it is required. Even more, when infants are susceptible to diseases such as bronchiolitis or pneumonia.
The therapy improves the gasses exchange and breathing. Its use in babies is essential, since their respiratory system is still developing and it may present oxygenation problems.
In outpatient therapies
It provides relief in chronic diseases such as asthma and cardiac insuffiency. Depending on the particular requirements of the patient, it can be carried out once or twice a week until the user’s condition is restored.
We perform it when the patient is hospitalized and sometimes immobilized.
In these cases, we recommend respiratory and motor physiotherapy during the stay. A daily session improves or prevents the development of some respiratory disease and it strengthens lung function.
In home therapies
It is indicated for patients who has been discharged and are in their recovery phase.
It can improve the health of the patient in cardiac events (heart attack), respiratory disorders or transplants.
We will do it once or twice a week. In this process, the patient should perform daily kinesiotherapy exercises that are indicated.
The healthcare professional can be supported by equipments that do more fluid secretion and facilitate its removal, such as nebulizers and flutter (small pipe-shaped device with a steel ball inside).
Respiratory physiotherapy in COVID-19 times
Severe COVID-19 patients can spend a lot of time in intensive care, being immobile and connected to breathing apparatus. Infection, inflammation and lack of movement lead to significant loss of mass muscle, including the respiratory muscles.
Pneumonia is one of the main diseases caused by a virus. This condition causes lung function to be decreased in a great way.
In recovery, the lung tissue is severely affected, with scars and thickenings that make it difficult for oxygen to reach the capillaries and, therefore, they affect breathing.
The alteration caused by pulmonary fibrosis is gradual and irreversible, but if caught early and treated, it can be delayed or stopped.
In addition to respiratory sequelae, as a result of prolonged immobility, muscle atrophy develops with reduced strength and joint mobility in extremities and trunk.
Respiratory physiotherapy includes, in these cases, physical exercises and tips on managing symptoms and sequelae to improve quality life of the patient.
Physiotherapy exercises. Treatment and prevention
There are different techniques with which we will help the patients in their recovery and maintenance of health. Among these, we can find:
1. Postural drainage. It is the most popular technique for removing secretions. The goal is to get the mucus to drain into the larger bronchi and trachea by effect of gravity and to be expelled with coughing. It is important that the patient knows how to cough and breathe deeply.
2. Expansion exercises. It involves expanding the thorax with big hold inspirations, retention and slow expiration.
3. Diaphragmatic breathing. It refers to periods of slow breathing with the relaxation of the accessory muscles, together with the diaphragmatic breathing.
4. Chest percussion. They are continuous tapping with the hollow of our hand.
5. Chest vibration. Hands are placed on the rib cage and it produces a vibration with the breathing. They combine the compression and postural drainage. It serves to dislodge secretions attached to the bronchial walls.
6. Chest compression. It is done with a hug that compresses the rib cage, where pressure is applied to the lower and lateral portions of thorax and sternum.
7. Intended coughing. Coughing can be triggered by gently pressing on the trachea when inspiration ends. It allows mucus (that has been removed) to be expelled or it can be swallowed.
Although physical therapy is not a substitute for medical treatment, it complements and improves its effectiveness.
It helps to accelerate the recovery of the patients so that they can breathe freely.