Living Well With Cystic Fibrosis: A Guide To Respiratory Physiotherapy

Cystic fibrosis is a genetic disease that can cause a variety of clinical manifestations. To try to better understand the pathology of this disorder, it is important to analyze the specific anatomical structures that will be affected by this pathological process.

 Signs and symptoms

 Cystic fibrosis may be asymptomatic; This occurs when a person inherits only  one faulty gene from  their parents and is a carrier of the disease. How cystic fibrosis develops and the severity of its symptoms vary between individuals. The disease  sometimes manifests soon after birth, but in some cases of cystic fibrosis, it is not detected until months (in infants) or years (in childhood).  Signs and symptoms vary from person to person and  may include:

  • Tired
  • The skin tastes salty
  • Persistent cough with phlegm
  • Wheezing and difficulty breathing
  • Lung infection
  • Poor growth and weight loss
  • Difficulty defecating during the first 24/48 hours of life.

 Physical therapy management

The primary goal of physical therapy is to prevent secondary complications and improve quality of life by eliminating excessive mucus secretion, maintaining or improving lung function, and facilitating Musculoskeletal treatment if necessary. (Rowe, 2009).

 Chest physical therapy

People with cystic fibrosis will need intensive chest physical therapy. This will include the following:

Strong massage helps loosen  sticky phlegm

Postural drainage:

The positions are supported by gravity  to aid drainage of secretions and also help increase  air movement or ventilation to different parts of the lungs. 


This technique is also known as chest percussion and is used to help release secretions. To perform this technique, one uses a cupped hand  to hit the chest firmly and rhythmically (on a layer of clothing or a towel).

 Shake and vibrate:

This technique involves some brief rhythmic pressure on the chest during exhalation to mobilize secretions.

 Regular assessment and monitoring is necessary during physical therapy treatment, as patients may require supplemental oxygen, especially in cases of advanced cystic fibrosis.

 Other techniques include:

 Active respiratory cycle  (ACBT):

This technique includes controlled breathing (BC), chest expansion exercises (TEE) and forced exhalation technique (FET).

Breathing control (BC):

Relaxed diaphragmatic breathing  allows you to rest and  avoid any constriction of the airways, which can make it difficult to clear secretions.

 Thoracic expansion exercises (TEE):

Deep breathing exercises  help the lungs  expand more effectively and allow air to pass through the secretions so  they can be “pushed” through the respiratory tract toward the mouth. Breathing should be slow and deep, pausing at the end of the inhale, followed by a calm, relaxed exhale.

 Forced exhalation technique (FET):

This involves blowing or sighing to help move secretions from the smaller airways into the larger airways, where they can be cleared more easily. 

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