physio for cystic fibrosis

[Thaseen]

Hi. Can anyone tell about physio of cystic fibrosis? PLEASE DO THE NEEDFUL.

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[Hessa]

before begin PT You have to asses the pt
do ascultation see what side of the lung he or she had crakles ( sound of secreation ) or wheeze ( due to narowing of the air way. then have alook at the chest x ray>> to see if there is any caludation area ( blockage of the lung)
once You know the most common site for secreation You have to start with some breathing excercise like ACBT ( active cycle breatning techneque) it helps to loosen the sticky secreation and preparing the chest for postural drinage>
( ACBT) done bay doing 3 abdominal beathing followed by 3 huffing
then do postural drinage according to the most lobe effected accompaned with cgest clubbuing and precussion, or vibration if you dealing with new boarn or infant or geriatric pt ( cause the rib is soft)
then ask pt to cought to take out of secreation
you have to ask pt to walk before chest PT, drink water or warm herbal tea to help soften the secreation ad dilate the air tube...
jumping on a trampolied also it works with child wit CF or cycling
this Chest PT is good for out pt or pt in the word>>
if the pt in the ICU so you have to do other thing including postural drinage mainly side ling position with clubing and vibration, and percussion followed by suction and manual hyperinfltation

[polash_000@yahoo.com]

HI,
YOUR plan of RX is very helpfull,Can u please tell me how many RPT need for a international CICU with 18 bed.

[sarahwatt]

In response to CF question, flutter valves and accapellas are also very helpful instruments that the CF can use by themselves to facilitate secretion clearance. They need regular expectoration, and this gives them a lot more independance.
Accapellas are better because they are not gravity dependent, so can be used in different postural drainage positions.
Sarah

[estherderu]

dear everybody,
The International Physiotherapy Group for Cysitc Fibrosis has published a list of international contact persons.
e-mail addresses
Updated August 2007
Chairperson: Filip van Ginderdeuren
Vice Chairperson: Maggie McIlwaine
Treasurer: Jovita Zerlik
Secretary: Esta-Lee Tannenbaum (esta.tannenbaum@rch.org.au or etannenbaum@hotmail.com)

1. Argentina: Marcela Baldoni marcelabaldoni@hotmail.com
mbaldoni@fibertel.com.ar
2. Australia: Brenda M. Button brendab@unimelb.edu.au
b.button@alfred.org.au
3. Austria: Béatrice Oberwaldner beatrice.oberwaldner@meduni-graz.at
beatrice.oberwaldner@klinikum-graz.at
4. Bangladesh: Md.Abdullah Al-Mamun abdullah15ca@yahoo.ca
5. Belgium: Filip van Ginderdeuren filip.vanginderdeuren@uzbrussel.be
6. Brazil: Hilda Angelica Jimenez hjimenez@metalink.com.br
7. Bulgaria: Anni Konfarjievea (Mapnera)
Paediatric Clinic, Bul "J. Sofirski" No. 1, Sofia, Bulgaria
8. Canada: Maggie McIllwaine mmcilwaine@cw.bc.ca
9. Cayman Islands: Zillah Isaac zillah.isaacs@gov.ky
10. Chile: M. Alejandra Vila Irarrazavel
Monsenor Escriva de Balaguer 5721, Santiago, Chile
11. Colombia: Janeth Buendia Algeria
Cra 46# 8895 Apto. 1104, Torres de Tequendama, Cali, Colombia
12. Costa Rica: Rodolfo . A . Bonilla Abarca rhbonilla@yahoo.com
rhbonilla@hotmail.com
13. Cuba: Romariao Arjona Rodrigues
Hospital Pediatrico Docente, "Juan Manuel Marquez"
Ave 31 Y Calle 76, Maranao, Ciudad de la Habana, Cuba
14. Czech Republic: Libuse Smolikova libuse.smolikova@lfmotol.cuni.cz
15. Denmark: Bente Kristensen bentekri@rh.dk
16. Ecuador: Maite Mijares maite@crespomijares.com
17. El Salvador: Maria Azucena Flores de Melendez
lemamelendez@saltel.net
18. Estonia: Karin Tammik
6 Lunini St., Tartu University Children’s Clinic
Tartu EE 2400, Estonia or Estonian Associations address
19. Finland: Leena Jokinen leena.jokinen@heli.fi
20. France: Hugues Gauchez hgauchez@CH-LOOS.FR
21. Greece Kostas Katsoulakis katsoul@freemail.gr

22. Germany: Jovita Zerlik jovita.zerlik@kinderkrankenhaus.net
23. Hong Kong: LAU Mo Yee, Polly pmylau@ha.org.hk
24. Hungary: Peter Borka borka@chello.hu
25. Iceland: Anna Gudny Eriksdottir
Breidvngur 2, 220 Hafnarfjordur, Endurhaedingardeild Lands Pitalans
101 Reykjavik, Iceland
26. India: Sumita Gupta bisoiak@rediffmail.com
27. Ireland: Irene Maguire paedsphysio.uchg@mailn.hse.ie
28. Israel: Vivi Armon vvarmon@yahoo.com
29. Italy: Mr Paolo Buonpensiero pbuonpe@yahoo.it
30. Lithuania: Rima Budreciene rbudreckiene@ hotmail.com
31. Litvia: Inese Znotina ineseznotina@yahoo.com
32. Macedonian: Biljana Pacevska
The Paediatric Clinic, Vodnjanska 17, 91000 Skopje, Macedonian
33. Mexico: Zoila Popper amfqmx@mexis.com
34. New Zealand: Rebecca Udy RebeccaU@adhb.govt.nz
35. Norway: Sandra Gursli sandra.gursli@ulleval.no
36. Oman: Nasser Saeed Al Hajry mwazakid@yahoo.com
nhajri@edu.om
37. Panama: Gherson Cukier gcukier@chiriqui.com
ghersonc@hotmail.com
38. Poland: Teresa Orlik zul@imid.med.pl
39. Portugal: M Camila Canterio
Servico da Readaptacao Funcional Respiratoria
Departarnento de Pneumolgia do Hospital Puli to Valsnte
Alamada des Linhas de Torres , 117 Lisboa, Portugal
40. Romania: Zagorca Popa zagorcapopa_tm@yahoo.com
41. Russia: Alena Sherbakova russia-cf@mtu-net.ru
42. San Salvador: Azucena Flores mafa_azucena@msn.com
mafa_azucena@integra.com.sv
43. Saudi Arabia: Tareq M Aref Hussein
Respiratory Care Dept (MBC #51 )
King Faisal Specialist Hospital and Research Center
P.O. Box 3354 , Riyadh 11211
44. Slovakia: Marta Heroutová herout@sudtarch.sk
45. South Africa: Brenda Morrow bmorrow_staff_ich_rxh_uct@mail.uct.ac.za
46. Spain: Nuria Lopez fq@retemail.es
47. Sweden: Louise Lannefors louise.lannefors@med.lu.se
48. Switzerland: Patrick Althaus p.althaus@smartfree.ch or
patrick.althaus@berufsbildung-srk.ch
49. The Netherlands: Jettie Nomden j.g.nomden@rev.umcg.nl
50. Turkey: Osman Coban osmancbn@yahoo.com
51. UAE: Saeid Rahbar Soureh saeed849@yahoo.com
52. United Kingdom: Lynne Gumery lynne.gumery@heartofengland.nhs.uk
53. Uruguay: Kitty Löwensberg kittylowensberg@movinet.com.uy
54. USA: Jan Tecklin Tecklinj@arcadia.edu

For more information you can search the following site: Welcome to the INTERNATIONAL PHYSIOTHERAPY GROUP FOR CYSTIC FIBROSIS
kind regards
esther

[fire_ice]

regarding the management ,most of the things have been dealt , i would like to make a point that for the patients in ICU and out patients make sure that broncho dilators through nebulization if indicated be given before attempting for any chest physiotherapy this will help in draining the secretions better...

[polash_000@yahoo.com]

In response to CF question, flutter valves and accapellas are also very helpful instruments that the CF can use by themselves to facilitate secretion clearance. They need regular expectoration, and this gives them a lot more independance.
Accapellas are better because they are not gravity dependent, so can be used in different postural drainage positions.
Sarah

hi,can we use postural drainage for various resoan for dry the lung.

[sarahwatt]

Dear polash000,

I'm not quite sure what you are asking.
Postural drainage positions put different areas of the lungs in gravity dependent positions, to help drain secretions from that particular area of the lung e.g. (R) mid lobe.
What was the question you were asking? Does that help?

[fire_ice]

postural drainage is one of the most helpful means to clear the chest for patients with cystic fibrosis!!!!!!!i think this is what u have asked as ur question is not clear

[phyllphys]

You may want to consider teaching autogenic drainage which is an effective way for the individual with CF to clear secretions independently whereas postural drainage with percussion usually requires the assistance of another to do it effectively for all lobes.

[fire_ice]

definitely i totally agree with u it is more active and no assistance is required........but for patients with cystic fibrosis we teach self administration of postural drainage tech. as it very handy for them considering the nature of the disease and regarding the application of the percussion if the patient is comfortable he can do self percussion with one hand but usually the patients tend to hold the breath while doing so and if so is the case , we advise not to do any percussion.

[morwenna]

........ regarding the application of the percussion if the patient is comfortable he can do self percussion with one hand but usually the patients tend to hold the breath while doing so and if so is the case , we advise not to do any percussion.

A "flutter" or A Cappella device (as mentioned above) is a good alternative to percussion/shaking as it gives intermittent positive pressure and has a similar effect in loosening secretions, with the benefit that the patient can treat themselves without getting exhausted!

This looks quite cool, to make physio more "fun" for youngsters! Flower - Home

[bardu28]

one of the autogenic drainage technique which I have learned from Filip van ginderdeuren when I was in Brussels.this techniques is modified and combined with flutter...I have created and uploaded it to Youtube for my Turkish CF patients.Im sorry it is turkish but u can get an idea how u can apply it...

YouTube - inhalasyon+otojenik drenaj

regards

[bardu28]

I have never applied Postural Drainage after I have learnt Autogenic drainage techniques..coz it is more effective than PD..

[fire_ice]

there is no doubt that Autogenic drainage is more effective than postural drainage but what about the childrens who r too yong to follow the instructions the treatment has to be passive so postural drainage is the option

[bardu28]

there are lots of ways which u can apply to small children..Autogenic drainage that modified for children are really effective and easy to use when it was compared to PD...
for example:Autogenic drainage combined with bouncing.

there is a pic of me while I apply AD to a small children...but it is applied on a ball to perform bouncing...

http://www.fizyoterapitr.com/images/belcika.jpg

regards

[fire_ice]

saw ur pic but still confused that how do u control the depths of breathing like high lung volume breath , mid lung volume etc.. in the patients who is too young to understand ur complex instructions.

[bardu28]

it is really good question..if u look at pic, u can see PT's hand placed over the lung...PT controls of deep of breath, give pressure on chest to control of inhaled or expirated air.(like throcic expansion exercises)...


regards

[fire_ice]

thanks that was really helpful i will try it too

[katana]

there are many devices that can be used to mobilize secretion that can do better than the traditional physiotherapy.. such as flutter , PEP, hi PEP,, and much more

there are proven to break down the secretion and making it really thin and easier to discharge

there are much better because there patient dependent, some of these devices can be used with some other postural drainage positions.

exercise is also benificial in these cases ,, specially for children with cf