Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient

Abstract

Physiotherapy should be offered to patients with a variety of medical respiratory conditions, with the aim of breathlessness management and symptom control, mobility and function improvement or maintenance, and airway clearance and cough enhancement or support. Strategies and techniques include: rehabilitation, exercise testing (including for ambulatory oxygen assessment), exercise prescription, airway clearance, and positioning and breathing techniques. Physiotherapy may be helpful for postural and/or musculoskeletal dysfunction and pain, and provide help in improving continence, especially during coughing and forced expiratory manoeuvres. Physiotherapists are usually central to the delivery of pulmonary rehabilitation and may be instrumental in the non-invasive ventilation service. Physiotherapists are frequently involved in the delivery of oxygen and some nebulised substances, as well as providing vital monitoring of, for example, ventilatory function and cough effectiveness. Some complementary therapies may be appropriate in some situations (Web Appendix 1).