In many rare lung diseases, and in BO, the ventilation and the proper self-cleaning of the small airways (bronchioles) is impaired. As a result, less oxygenated blood circulates to the heart and through the body which facilitates further inflammatory processes.
In order to loosen the mucus within the small airways and throughout the lungs, specific chest physiotherapy is required in addition to the regularly inhaled therapy. To perform such specific chest physiotherapy accurately, it is important that the child and the family are instructed properly by a qualified chest physiotherapist. The chest physiotherapy should be carried out regularly on a daily basis and should be supervised and adjusted to current changes and needs by a qualified physiotherapist on a regular, weekly or monthly, basis.
Mobilization of mucus
The patient and her or his family must learn independently how to master the daily chest physiotherapy such as autogenic drainage. Children from the age of 4 can start to learn some techniques. The aim of these exercises is to mobilize mucus and mucus plugs which will enable the child to cough up. Thus, lung function and gas exchange improve significantly. There are further devices for your child to support and to facilitate the mobilization of mucus. These aids include devices which prevent collapse of the small airways called bronchioles by increased resistance during exhalation and loosen the mucus by oscillation e.g. Flutter, PEP system, RC cornet.
Trampolines and devices from sport medicine such as bicycle ergometer, treadmill, and devices for muscle strengthening are effective and can be used in addition.
Keep the chest flexible
It is important to ensure good mobility of the chest, as difficult breathing and recurrent episodes of persistent cough can lead to reduction in chest mobility. Manual techniques or exercises with specific physiotherapeutic equipment such as „Pezziball“ can be used for this purpose.
Start physiotherapy early
Respiratory physiotherapy should be started early after diagnosis. There are several reasons for this: smaller children are more willing to integrate daily physiotherapy into their daily routine than adolescents. They learn the breathing techniques in a playful way. Once the therapy is firmly established, adolescent will continue the technique naturally. Furthermore, body perception and sense of well-being are trained early in young age.
Find a therapist
Unfortunately, there are not many physiotherapists which are specifically trained in pediatric respiratory physiotherapy and rare lung diseases. We would always recommend to speak to your pediatric pulmonologist and to your local pediatrician. They may be able to find a physiotherapist nearby with experience in other lung diseases such as cystic fibrosis or adult respiratory medicine.