Physiotherapy and airway clearance in PCD
Why airway clearance matters, common techniques, and how to build a routine that fits your life.
Why physiotherapy is essential
In healthy lungs, cilia move mucus upward like an escalator. In PCD that escalator is slow or not moving, so airway clearance helps break the cycle of mucus → infection → inflammation → airway damage.
Active Cycle of Breathing Technique (ACBT)
• Breathing control – relaxed breathing with longer exhale than inhale.
• Thoracic expansion – deep breaths to loosen mucus.
• Huffing/forced expiration – controlled huffs to move mucus into larger airways for clearance.
Postural drainage
Uses gravity-assisted positions to help drain mucus from different lung segments. Often combined with percussion/vibration and breathing techniques.
Autogenic drainage
• Unsticking phase – gentle breathing at low lung volumes to mobilise mucus.
• Collecting phase – moderate breaths to move mucus into larger airways.
• Evacuating phase – deeper breaths and controlled exhale followed by huff/cough.
Note: Requires practice and concentration; can be done in many positions and can suit busy routines.
Devices that may help
• PEP devices (e.g., Pari PEP, Aerobika) provide resistance to keep airways open and move secretions.
• Oscillatory PEP (e.g., Acapella) adds vibration to loosen mucus and mobilise it toward the larger airways.
Note: A physiotherapist should assess and teach the technique/device that’s right for you.
Extra tips
• For young children: make physio playful (bubbles, kazoos, blowing games, puppets).
• Posture matters – poor posture can reduce lung function.
• Exercise is powerful for airway clearance and wellbeing.
This fact sheet provides general information only and is not medical advice. Always follow guidance from your respiratory/ENT/physiotherapy team.