Positioning - Respiratory Treatment - Treatments

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What is positioning?

Positioning is important in respiratory physiotherapy to maximise breathing, and encourage secretions (phlegm) to move up from the bases of the lungs up into the larger airways so they can be coughed out.

Above: Active cycle of breathing exercises supervised by a specialist therapist

Respiratory physiotherapists use a number of assessment techniques to decide which position would be most effective. These techniques include:

Observation
Auscultation
Percussion
Chest x-ray review
Medical history

Depending on the assessment findings, a number of positions may be advised to achieve the proposed goals. Common goals are likely to include:

Opening up sections of the lung that sound quiet (due to reduced airflow),
Encouraging secretion distribution up and of the lungs
Maintaining comfort
Maximising perfusion (gas exchange)
Reducing work of breathing (shortness of breath)
Maximising ventilation (getting air into the lungs)

The positions used by your respiratory physiotherapist may include:

Supine lying – lying on your back
Prone lying – lying on your front
Side lying
Alternate side lying
Sitting
Standing

Pillows and wedges provide a useful tool for your respiratory physiotherapist for a number of reasons including:

To enhance comfort
To hold you into a particular position - this is particularly useful in patients who are unable to readjust their position independently, or unable to hold a position for a sustained period of time
To position limbs appropriately to maximise chest expansion

What are the benefits of positioning in respiratory physiotherapy?

Positioning has a number of benefits, these include:

Requires limited / no effort from the patient – particularly beneficial in patients unable to readjust themselves
Positions can be modified to reduce the shortness of breath that may be brought on by other positions
Comfortable for the patient due to its non-invasive nature

Who would benefit from positioning for a respiratory condition?

Any patient with a respiratory condition should be assessed in order for a respiratory physiotherapist to provide advice on best positioning.

Positioning is particularly beneficial as a passive technique, for people who are unable to participate in active physiotherapy techniques due to:

paralysis
weakness
neurological condition
acute illness
fatigue
lack of comprehension

Regular auscultation will allow positions to be modified to best manage your condition following any developments. Our respiratory physiotherapists will also be able to advise you on the best positions for sleeping should this be proving an issue due to shortness of breath.

For a respiratory assessment or to find out how respiratory physiotherapy can help you, please call Physio.co.uk today on 0330 088 7800. You can also book appointments online using our online booking system

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