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The role of the physiotherapist in cystic fibrosis focuses on airway clearance (clearing mucus from the lungs) with the use of various techniques to help the individual to breathe better. It also seeks to improve the general quality of life of the individual.

Breathing exercises
There are different forms of breathing exercises which can be performed. This helps to clear mucus from the lungs to be expectorated through the mouth. Breathing exercises can be initiated in the form of games for children.

A variety of breathing techniques such as Active Cycle of Breathing Technique, Autogenic Drainage,Thoracic Expansion Exercises etc can be used for affected individuals.

The Active Cycle of Breathing Technique comprises three different methods. One aspect involves the individual taking in normal breaths in and out.

Another aspect involves taking in a deep breath so that you feel your chest expand and the last technique involves breathing out through the mouth (huff-so the mouth ought to be opened).

There are different forms of breathing exercises which can be performed

It is a cycle because it uses all these three different techniques to clear mucus from the lungs. One individual may require more of chest expansion techniques and less of breathing out through the mouth while another may require taking in more normal breaths. The Active Cycle of Breathing Technique can be tailored to suit many individuals.

Techniques
Manual techniques such as percussions and vibrations are also performed on an individual with cystic fibrosis. These techniques help to loosen up the thick mucus so that it can be cleared out of the lungs easily. The technique is performed on the individual while he/she is sitting or lying down.

When the individual is lying down, the head of the bed is usually raised to assist the person to breathe better.

The physiotherapist usually places his or her hands on the patient’s chest to perform these techniques. In some cases, a cloth or a towel is placed over the chest before the physiotherapist performs the percussions to make the individual more comfortable.

The manual techniques can be performed twice in a day to assist in clearing mucus.
There are also hand-held airway clearance devices which also assist the individual to clear the mucus.

Aerobic Exercises
Exercise is strongly advised for individuals with cystic fibrosis, therefore, they are encouraged to include some exercises in their daily routine.

Activities such as jogging, jumping rope, basketball, football etc form an aspect of their therapy and aids in the clearance of mucus from the lungs.

Exercises enhance the ability of the chest to expand more and hence deeper breaths are taken and most of the bad air is also expelled.

Physiotherapy is crucial to assist in airway clearance, decrease the rate of lung function, decline and contribute to an improved quality of life of the affected individual.

The writer is a Senior Physiotherapist at the 37 Military Hospital

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