Respiratory physiotherapy in stable COPD

Historically, “chest physiotherapy” has referred to a group of techniques that aim to clear secretions from the lungs and make breathing more comfortable and possibly more efficient. It is not a particularly accurate descriptive term, and today most therapists describe this aspect of their practice as cardiorespiratory or cardiopulmonary physiotherapy because it describes the interaction between these two organ systems that must be considered when trying to improve an individual’s respiratory function. What is more, physiotherapy for those with chronic obstructive lung disease (COPD) is no longer confined to secretion clearance techniques or breathing exercises. Physiotherapy is the art and science of using a variety of modalities to optimize physical performance. Although exercise has been the cornerstone of physiotherapy practice, for many years therapists ignored the value of exercise for individuals with COPD. The misconception that individuals with chronic lung disease should rest and avoid dyspnea has been recognized and clinical practice changed to better address the needs of this group of patients. This chapter will examine the value of traditional chest physiotherapy techniques, which aim to improve secretion removal and breathing efficiency in pulmonary rehabilitation for individuals with COPD. It will also review the role of exercise for this patient population.