The physiotherapist is an important part of the team that assists people with PCD. The physiotherapist will primarily assist people with PCD by:
- Teaching them how to most effectively and efficiently help clear their airways using ‘airway clearance techniques’
- Giving advice and instruction on appropriate exercise and physical activity
- Discussing how best to use nebulised medications.
Airway Clearance Techniques
In PCD, the tiny cilia that line the airways and help keep them clean and free from infection are not working effectively. This leads to a build-up of mucus and more frequent respiratory infections leading to airway damage. Airway clearance techniques are a way of helping move the mucus from the small airways in our lungs to the larger airways where they can be more easily coughed out, thereby helping to prevent infections. There are a variety of airway clearance techniques that people with PCD can perform to help mobilise mucus out of their lungs. Some examples are:
- Manual chest physiotherapy, also known as chest percussion
- Positive expiratory pressure (PEP) therapy
- Oscillating PEP therapy
- Breathing techniques such as The Active Cycle of Breathing Technique (ACBT) and Autogenic Drainage (AD)
After the mucus has been mobilised, other techniques such as huffing and controlled coughing are used to help clear the mucus out of the lungs.
Inhalation therapy refers to medications that are delivered as an aerosol directly into the lungs. These medications include:
- Mucolytics: these drugs make mucus less thick so they are more easily moved out of the lungs
- Antibiotics: directly delivering antibiotics to the airways via a nebuliser is used to obtain a high concentration of an antibiotics in the airways to help fight bacterial infections
- Bronchodilators: are used to help relax or open up the airways in people with PCD who benefit from this therapy. These drugs are delivered either through metered dose inhaler (puffer) or through a nebuliser.
The way these medications are delivered also has a significant effect on how effective they are, therefore your physiotherapist will discuss how best to take these medications as well as what equipment to use and how to maintain the equipment.
Exercise is another important part of keeping well when you have PCD. It is well known that people with a variety of chronic lung diseases benefit from regular exercise. Some of the benefits include having fewer chest infections, coming into hospital less often and needing to take fewer medications.
Your physiotherapist will help you develop an exercise/activity program that will help keeping you well and also address some of the muscle imbalance and postural issues that can occur in some people with PCD.