All people with CF lung disease will need to use some type of Airway Clearance Technique (ACT) to assist with loosening the thick, sticky mucus that builds up in the lungs, making it easier to remove by coughing or huffing.
Younger children require assistance from adults to carry out these techniques, but as they get older, as with adults with CF, they can carry out their ACTs themselves.
Your Physiotherapist will direct you regarding which techniques are best for you and fully instruct you about how and when you should carry them out. You should consult your physiotherapist before making any changes to your regime.
Percussion involves ‘clapping’ the chest firmly with a cupped hand, and vibrating the chest to loosen mucus in the lungs. The length of treatment sessions will vary according to need.
At first, the parents or caregivers who care for the child should do the percussion therapy, but relatives and friends can also learn the techniques, in order to give the parent some respite from providing therapy.
Breathing exercises can be introduced in the form of games from about the age of two and by about nine years old most children should be able to do some parts of their physical therapy for themselves.
Most teenagers should be fully independent and may only require assistance during periods of unwellness.
A Physiotherapist may teach various breathing techniques such as huffing, a gentle type of cough done by tightening the stomach muscles (like fogging up a mirror), or Active Cycle Breathing, a technique that uses controlled deep and shallow breathing to move mucus through the airways.
PEP therapy involves breathing through a mask or mouthpiece where back pressure is created in the lungs. This can assist with expanding the small airways and getting air behind the secretions, moving them to larger airways where they can be more easily cleared.
Children can participate in PEP games, by using a straw to blow bubbles in a bowl of water with dish detergent.
Flutter therapy is an extension of PEP, and uses a hand-held device that quickly oscillates the air pressure. This oscillation causes mini bursts of air flow that do the same work as PEP