- For
- Sputum you cannot clear
- Duration
- 30–45 minutes
- The real goal
- You doing it yourself
Who this genuinely helps
Airway clearance has a clear place for adults with bronchiectasis, some chronic lung conditions that produce excess sputum, respiratory muscle weakness, and in the period after certain operations, when coughing becomes weak or painful. The European Respiratory Society statement, drawing on 30 randomised trials, reports these techniques increase sputum clearance, reduce the impact of cough, and improve quality of life.
What it is not for: an ordinary cough or cold, a sore throat, or a dry cough. If there is no sputum, or you can already clear it easily yourself, this adds nothing — and we will say so.
The techniques we teach
The one used most is the active cycle of breathing technique (ACBT) — controlled breathing, deep breaths to open the lower parts of the lung, then huffing: breathing out through an open mouth as if misting a window, which moves mucus up towards the throat without the exhausting force of hard coughing.
We also use gravity-assisted positions where appropriate, positive expiratory pressure devices, and — often the one that makes the most difference — physical exercise. In one survey of 121 physiotherapists treating acute exacerbations, exercise was the one most often rated effective. That is clinician opinion rather than an effectiveness trial, and we report it as such.
The aim of a session is not to keep you coming back. It is for you to be able to do it yourself at home, at the right times, without us.
Frequently asked questions
Is this the same as chest physio with tapping?
Not exactly. Percussion or tapping is one of the older techniques and is now used far more selectively. More often used today are active breathing techniques you perform yourself, because the effect is comparable and you are not dependent on someone else to do it.
I smoke and bring up sputum in the mornings. Do I need this?
The thing that would help you most is not this therapy but stopping smoking — no breathing technique comes close to matching that effect. Persistent sputum should also be assessed by a doctor first, because it can point to a condition that needs diagnosing rather than just clearing.
How many visits does it take?
Usually few. Most people have it down in one to three sessions, then do it themselves every day. Further visits are only needed if the condition changes or the technique needs adjusting.
Sources
The figures and recommendations on this page come from the sources below. The links go to third-party sites.
- Lee et al. — Airway clearance techniques for bronchiectasis, Cochrane
- European Respiratory Society statement on airway clearance techniques in adults with bronchiectasis
This page is educational and does not replace an examination by a doctor. If your child is unwell, or something does not feel right to you, have them seen first.