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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Respiratory

Chest Physical Therapy (CPT) (4916)

Chest Physical Therapy (CPT) (4916) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Respiratory

4916



Chest Physical Therapy (CPT)

Chest physical therapy (CPT) is a treatment that helps remove mucus from the lungs. Some
people only need it for a short time after having a lung illness. Those with chronic lung disease
need to have these treatments daily. CPT consists of two therapies called postural drainage, or
positioning, and percussion, clapping, or cupping.

Postural Drainage
Postural drainage removes mucus from certain parts of your lungs by using gravity. By placing
yourself or your child in different positions, mucus drains to the bigger airways where it can be
coughed out.

Scheduling the Treatment
CPT works best in the morning. This allows mucus to be removed that has built up during the
night. Sometimes a treatment can be done before bed to reduce coughing while sleeping. Make
sure you do CPT before meals or wait at least 1-2 hours after eating before starting. This helps to
prevent nausea and/or vomiting.

Positioning
The pictures on pages 3 – 6 show the positions that drain mucus from certain parts of the lungs.
If you are draining the lower lung areas, tilt the chest area 10-20 degrees below the hips. This is
done by:

ξ Propping firm pillows or cushions under your hips, on the bed, floor or couch
ξ Using a positional lounge chair
ξ Before beginning the treatment, wash your hands with soap and warm water, or use
anti-bacterial hand gel, to reduce the risk of infection.

Note: If your child is under the age of 5 or has Cystic Fibrosis, you will keep the chest
horizontal, not tilting the child’s head down, while doing percussion.
The child should remain in each position for at least 3 minutes. If you find that your child
coughs up a lot of mucus when in certain positions, spend more time draining these areas.

Deep Breathing and Coughing
Deep breaths should be taken once in a while during the treatment. This helps expand your lungs
and strengthens your cough. A cough should be done after each position of percussion.










Percussion
Perform CPT by clapping with a cupped hand or rubber palm cup, over the part of the lung being
percussed. The cup forces a cushion of air against the chest wall, which vibrates the lungs and
loosens secretions. Hold your hand as shown below to form a cup for percussion.



Percussion should be done on the round areas shown on each postural drainage picture, and
should always be done over the rib cage. Never percuss over the spine, breasts, breast bone
(sternum), or IV, chest tube or fresh surgical sites on the chest. CPT should also be done over a
thin article of clothing or a towel, never on bare skin.


Percussion should last 3-5 minutes per area being drained. Areas that have a lot of mucus may
need more time.

If cupping is hard to do, or your hands are too large for the chest wall area, soft plastic hand-held
percussor cups may be used. A mechanical percussor may be used instead of hand or cup CPT
for patients with brittle bones or surgical sites.

Vibration
Vibration is a technique that also helps the movement of mucus. You will need someone to help
you. Have your helper place their flattened hand over the area that was percussed. When you
take a breath in and exhale, the helper should rapidly but gently shake your chest while you
exhale. Repeat this process three times after percussing each position. Follow all vibration
therapies with a cough.














Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 9/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing.HF#4916

Chest Physical Therapy Positions for Infants and Children

Below are the drainage positions for CPT. The white ovals show you where to percuss.

Upper Lobes

Lean forward 30 θ. Percuss between the collar bone and the shoulder blade on each side of the
chest.



















Lean back 30 θ. Percuss between the collar bone and the nipple on each side of the chest.









Lower Lobes

The body should be positioned with the child’s head down 10-20 θ and lying on the right side.
Percuss on the left side below the underarm. Note: If your child is under the age of 5 or has
Cystic Fibrosis, you will keep the chest horizontal, not tilting the child’s head down, while
doing percussion.


















Horizontal Head down 10-20º


The body should be positioned with the child’s head down 10-20 θ and lying on the left side.
Percuss on the right side below the underarm. Note: If your child is under the age of 5 or has
Cystic Fibrosis, you will keep the chest horizontal, not tilting the child’s head down, while
doing percussion.

Horizontal Head down 10-20º


The body should be positioned head down 10-20 θ and lying on the abdomen. Percuss between
the lower edges of the rib cage and behind the underarm on each side of the spinal cord. Note:
If your child is under the age of 5 or has Cystic Fibrosis, you will keep the chest horizontal,
not tilting the child’s head down, while doing percussion.















Horizontal Head down 10-20º



The body should be positioned head down 10-20 θ and lying on the back. Percuss on the front of
the chest in the nipple area and just below. Note: If your child is under the age of 5 or has
Cystic Fibrosis, you will keep the chest horizontal, not tilting the child’s head down, while
doing percussion.
.















Horizontal Head down 10-20º








Chest Physical Therapy Positions for Adults

Upper Lobes
While sitting lean back against a pillow.
*Percuss just below the collar bone above
nipples


Lower Lobes
Lie on your back with head lower than hips.
*Percuss just below the nipple area





Lie on your left side with your head lower
than hips. *Percuss on right side below
underarm.







While sitting, lean forward against a pillow.
*Percuss between the collar bone and
shoulder blade.



Lie on your stomach with your head lower
than your hips. *Percuss lower edges of rib
cage on each side of the spine.







Lie on your right side with your head lower
than hips. *Percuss on left side below
underarm.