Chest Percussion: What Is It and How Is It Used in COPD?

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Chest percussion is used frequently in chronic obstructive pulmonary disease and other conditions (such as cystic fibrosis) to help you clear your airways.

It literally involves "percussion" on your chest and/or back — in other words, your partner or a health care worker will clap you on your chest or back to help loosen the thick mucus in your lungs. Chest percussion also can be performed using electronic devices or other instruments that vibrate your chest.

When you loosen mucus using chest percussion, it will help you to cough it up.

Chest percussion is considered a part of chest physical therapy. The overall goal of chest physical therapy is to make it easier for you to expel mucus in your airways, which in turn should make it easier for you to breathe.

Performing Chest Percussion

Your doctor or respiratory therapist will give you specific instructions on how to perform chest percussion. You should always follow the instructions of your health care team, but here are some general guidelines on how the procedure normally is performed.

You'll likely be instructed to perform chest percussion at least once per day in several different positions: seated; on your back with a pillow under your chest so that your head tilts downward; and on your stomach, again with your head tilted downward.

If you're using a mechanical airway clearance device for your chest percussion, your doctor will show you how to use the device.

If you're doing the procedure manually, your partner (or a health care worker) will then clap you on the back or the chest (whichever is exposed) with their hand, quickly and repeatedly.

It's important to use the correct hand position to perform manual chest percussion: the person's hand should be in a cupped position, with fingers and thumb together.

It's also important to clap on the sides of the chest and the back, not in the middle — your physician can show you exactly where.

Finally, you shouldn't perform the procedure on bare skin -- make sure you're wearing a shirt, or use a towel to cover the area to be clapped upon.

When to Perform the Procedure

The best time to perform chest percussion is in the morning, since it's likely that your lungs will have built up mucus during the night. If you have a problem with coughing overnight, you can consider performing it right before you go to bed, as well.

Of course, your doctor will advise you on the best times to perform the procedure. Chest percussion works best after a bronchodilator treatment, so you might want to keep that in mind.

It's not a good idea, though, to perform chest percussion right after you've eaten — banging on your chest or back following even a small meal could make you sick.

You should combine chest percussion with coughing or with other methods to bring up the mucus that's loosened by your efforts.

Chest percussion is often coupled with postural drainage and vibration, both of which can help loosen and drain mucus. If you're using postural drainage, you should hold your position for at least five minutes (or as long as your doctor advises) to allow as much mucus as possible to drain from your lungs.

Sources:

University of Michigan Health System. Postural Drainage and Chest Percussion fact sheet. Accessed March 12, 2016.

van der Schans CP. Conventional chest physical therapy for obstructive lung disease. Respiratory Care. 2007 Sep;52(9):1198-206; discussion 1206-9.

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