The Benefits of Chest Physiotherapy Treatment for Asthmatic Patients

28. October 2019

the benefits of chest physiotherapy treatment for asthmatic patients

Specialised physiotherapy offers a powerful, evidence-based approach to managing the daily challenges of asthma, a common long-term condition affecting the airways. For millions in the United Kingdom, asthma is a persistent reality, influencing daily activities, exercise capacity, and overall well-being. While medication is the cornerstone of asthma management, a comprehensive plan that includes specialised respiratory physiotherapy can significantly improve symptom control, enhance quality of life, and empower individuals to take a more active role in their health. This guide provides an in-depth exploration of chest physiotherapy, detailing its techniques, benefits, and practical application for managing asthma within the UK healthcare context.

Asthma is more common in boys than girls, but surprisingly when it comes to adults it is more prevalent in women than men. The reason is thought to be the change of hormones that girls go through during puberty that makes them more susceptible to asthma than men. This is your guide to what asthma is, current popular treatments, and innovative chest physiotherapy for asthmatic patients.

What is Asthma? A Deeper Look at the Condition

Asthma is a chronic inflammatory condition where the airways—the small tubes that carry air in and out of the lungs—become hyper-responsive to a wide range of stimuli.¹ This sensitivity means that when a person with asthma is exposed to a "trigger," their airways react in three main ways: the lining of the airways becomes swollen and inflamed; the muscles around the airways tighten (a process called bronchospasm); and often, an excess of thick, sticky mucus or phlegm is produced.¹ Together, these reactions narrow the airways, making it significantly harder to breathe.

This airway narrowing leads to the classic symptoms of asthma:

Wheezing: A high-pitched whistling sound made while breathing, particularly when breathing out.³
Coughing: Often persistent and may be worse at night or in the early morning.³
Breathlessness: A distressing sensation of not being able to get enough air.³
Chest Tightness: A feeling of pressure or squeezing in the chest.³

These symptoms are not constant; they can come and go, varying in severity. For many, symptoms worsen at night and in the early hours of the morning, a pattern linked to the body's natural daily hormonal cycles that regulate inflammation.¹

Asthma triggers are highly individual but often fall into common categories prevalent in the UK environment. These can include allergens like pollen, house dust mites, and animal dander; irritants such as cigarette smoke, traffic fumes, and strong perfumes; changes in the weather, particularly cold air; respiratory infections like the common cold or flu; and for some, exercise or even strong emotions.¹ This wide array of potential triggers underscores that asthma is not merely a simple breathing issue but a complex inflammatory disease with systemic interactions. Its established links to other atopic conditions like eczema and hay fever further highlight this complexity, suggesting that an effective management plan must be holistic, addressing more than just the lungs.¹

The Impact of Asthma in the UK: A National Health Challenge

Asthma represents a significant public health challenge in the United Kingdom. Currently, over five million people are receiving treatment for the condition, a figure that includes approximately 1.1 million children (1 in 11) and 4.3 million adults (1 in 12).⁷ The UK has one of the highest prevalence rates for childhood asthma in Europe, along with high rates of emergency hospital admissions.⁷

Disturbingly, a major UK study, the National Review of Asthma Deaths, found that two-thirds of asthma-related deaths are preventable.⁷ This stark statistic points to a critical gap in the standard approach to asthma care. It suggests that while medication is essential, there is a profound need for better self-management education and support. Patients often require more detailed, personalised training in how to control their breathing, clear their airways, and monitor their symptoms—skills that a brief GP appointment may not have the capacity to provide. This is precisely the gap that specialised respiratory physiotherapy is equipped to fill, elevating its role from a helpful addition to a potentially life-saving intervention. For those living with the condition, the daily impact can be profound, limiting participation in sports, affecting sleep, and causing anxiety about the next potential flare-up.³

Introducing Physiotherapy as a Key Management Strategy

In this context, a specialised physiotherapy treatment plan emerges as a vital component of modern, comprehensive asthma care. It works in synergy with prescribed medications to provide individuals with the skills and techniques needed to manage their symptoms proactively.⁶ Respiratory physiotherapy is not a cure for asthma, but it is a powerful tool for gaining control. Through a tailored programme, individuals can learn to clear mucus more effectively, improve their breathing patterns, strengthen their respiratory muscles, and ultimately enhance their overall quality of life, reducing the frequency and severity of debilitating flare-ups.⁶

What is Chest Physiotherapy?

The term "chest physiotherapy"—also known as chest physical therapy (CPT) or, more broadly, respiratory physiotherapy—can be misleading if viewed as a single, uniform treatment. In reality, it is a comprehensive and highly personalised approach that encompasses a collection of techniques and strategies designed to improve lung health and function.⁹ A qualified respiratory physiotherapist will conduct a thorough assessment to create a management plan that is uniquely tailored to an individual's specific symptoms, physical condition, and personal goals.⁶

Defining the Approach: A Personalised Toolkit for Your Lungs

At its core, chest physiotherapy utilises mechanical techniques, specialised breathing exercises, and sometimes assistive devices to improve the efficiency of the respiratory system.⁶ It is a hands-on, educational, and empowering field of physiotherapy. A central tenet of this approach is the understanding that the most significant and lasting benefits are achieved when the patient becomes an active participant in their own care. The techniques are the tools, but the real therapeutic value comes from the patient learning

how, when, and why to use them. This educational focus transforms the patient from a passive recipient of medical care into a knowledgeable and confident manager of their own condition, a shift that is crucial for living well with a long-term condition like asthma.

The Core Goals for Asthma Management

For an individual with asthma, a chest physiotherapy programme is designed to achieve several key, tangible goals that directly address the challenges of the condition.

Goal 1: Facilitate Airway Clearance
During an asthma flare-up or a concurrent chest infection, the airways can produce an excess of thick, sticky mucus (also called phlegm or sputum). If this mucus is retained, it can clog the smaller airways, worsening breathlessness and creating a breeding ground for bacteria, which can lead to secondary infections.10 The primary goal of many chest physiotherapy techniques is to help loosen this mucus and move it from the smaller, peripheral airways to the larger, central airways, from where it can be cleared more easily by coughing or huffing.11

Goal 2: Reduce the Work of Breathing
Living with inflamed and narrowed airways means the body has to work much harder to breathe. This can lead to the use of "accessory muscles" in the neck and shoulders, inefficient breathing patterns, and a persistent feeling of fatigue.17 A physiotherapist teaches techniques to normalise breathing patterns, encouraging the use of the diaphragm (the main breathing muscle) and reducing overall strain on the body. This leads to less energy expenditure on breathing and a reduction in the sensation of breathlessness (dyspnoea).15

Goal 3: Improve Lung Function and Gas Exchange
By clearing mucus and promoting more efficient breathing patterns, chest physiotherapy helps to optimise the function of the lungs. This ensures that more air can reach the parts of the lung where gas exchange—the vital process of oxygen entering the bloodstream and carbon dioxide being removed—takes place.13 The ultimate aim is to help the body receive the oxygen it needs more effectively, improving overall physiological function.9

Goal 4: Enhance Exercise Tolerance and Physical Fitness
Many people with asthma, particularly those whose symptoms are triggered by physical activity, develop a fear of exercise and become deconditioned over time.20 This creates a vicious cycle where lower fitness levels make them feel more breathless with less exertion. Respiratory physiotherapy breaks this cycle by teaching breathing control strategies to use during activity, helping to manage symptoms and build confidence. This allows individuals to improve their physical fitness, which in turn makes their muscles more efficient at using oxygen, further reducing breathlessness during daily tasks.6

Goal 5: Prevent Complications
By proactively managing mucus build-up and improving overall lung health, chest physiotherapy can play a crucial role in preventing secondary complications. Keeping the lungs clear reduces the risk of chest infections that might otherwise require antibiotics or even hospitalisation.11 For many, this proactive approach leads to fewer flare-ups, fewer emergency doctor visits, and a greater sense of control over their condition.11

A Detailed Guide to Chest Physiotherapy Techniques

The practice of respiratory physiotherapy has evolved significantly over the years. This progression reflects a deeper understanding of lung mechanics and a philosophical shift in chronic disease management—moving from passive treatments delivered to a patient towards active strategies performed by the patient. This evolution provides individuals with asthma a diverse toolkit, ranging from traditional, therapist-assisted methods to modern, independent techniques that promote self-efficacy.

Manual Airway Clearance Techniques: The Foundations

These are the traditional, hands-on techniques that often require the assistance of a trained physiotherapist or a family member who has been properly instructed.

Bronchial (Postural) Drainage

This technique is based on a simple principle: using gravity to help clear mucus from the lungs. The lungs are divided into different sections, or lobes and segments. By positioning the body in specific ways, a targeted lung segment can be angled downwards, encouraging any mucus within it to drain towards the larger, central airways.¹³ A physiotherapist will first use a stethoscope to listen to the chest and identify which areas of the lungs have retained secretions.¹³ Based on this assessment, they will guide the patient into one of several specific positions, often using pillows, wedges, or a tilted surface for support and comfort.¹⁶ Each position is typically held for 3 to 15 minutes and is often combined with percussion or vibration to maximise its effectiveness.¹⁹

Percussion (or Clapping)

Percussion is a technique used to mechanically dislodge thick, sticky mucus from the airway walls. It involves rhythmically and firmly striking the chest wall over the targeted lung segment with a cupped hand.¹⁹ The key to safe and effective percussion is the hand position. The hand is cupped as if holding water, which traps a cushion of air upon impact. This creates a deep, hollow sound and transmits kinetic energy through the chest wall to the airways without causing pain or stinging.²² It is critical that percussion is never performed directly on bare skin or over sensitive areas such as the spine, breastbone, stomach, or lower ribs, as this could cause injury to internal organs.¹¹

Vibration (or Shaking)

Vibration is a gentler technique that is often used in conjunction with percussion and postural drainage. It involves the therapist placing a flat hand firmly on the chest wall over the area being drained. As the patient breathes out, the therapist creates a fine, shaking motion by tensing their arm and shoulder muscles.¹⁴ This gentle vibration is transmitted through the chest wall, helping to loosen secretions and encourage their movement into the larger airways where they can be cleared.⁹

Breathing Control and Retraining Techniques: Taking Active Control

Reflecting the shift towards self-management, these techniques are active strategies that patients learn to perform independently to control their symptoms and clear their own airways.

The Active Cycle of Breathing Technique (ACBT)

ACBT is a cornerstone of modern respiratory physiotherapy in the UK and is highly effective for airway clearance.¹⁵ It consists of a flexible cycle of three distinct phases that can be adapted to an individual's needs ²⁵:

Breathing Control: This is the resting phase of the cycle. The patient breathes gently and slowly, using their diaphragm (placing a hand on the abdomen to feel it rise and fall). This phase helps to prevent bronchospasm and allows the individual to recover from more strenuous parts of the cycle.²⁵
Thoracic Expansion Exercises: These are deep breathing exercises. The patient takes a long, slow, deep breath in, holding it for 2-3 seconds at the top of the breath before breathing out gently. This helps to get air behind trapped mucus, pushing it out of the smaller airways, and helps to re-inflate any collapsed areas of the lung.¹⁶
Forced Expiratory Technique (FET): This is the mucus-clearing phase, also known as "huffing." It is performed after the thoracic expansion exercises have helped to mobilise the secretions.

Forced Expiratory Technique (FET) or "Huffing"

Often taught as part of ACBT, huffing is a highly effective and less tiring alternative to forceful coughing.¹³ A cough is an explosive manoeuvre that can cause smaller, inflamed airways to collapse, trapping mucus. A huff, by contrast, keeps the airways open. The technique involves taking a small to medium breath in and then performing a forced but not violent exhalation with the mouth and glottis (the top of the windpipe) open, as if trying to steam up a window or a pair of glasses.¹⁶ This creates a "huff" sound and effectively shears mucus from the airway walls, propelling it upwards. One or two huffs are usually followed by a period of breathing control.

Device-Assisted Airway Clearance: Modern Tools for Lung Health

A range of innovative handheld devices are now available to assist with airway clearance, offering another effective method for independent self-management. Many of these work on the principle of oscillating positive expiratory pressure.

Positive Expiratory Pressure (PEP) Therapy

PEP therapy involves breathing out against a resistance provided by a handheld device.¹³ This resistance creates a gentle back pressure in the airways, known as positive expiratory pressure. This pressure achieves two important things: first, it helps to "splint" the airways open during exhalation, preventing the premature collapse that can trap mucus in people with asthma; second, it promotes collateral ventilation, allowing air to move through alternative channels to get behind mucus plugs and push them towards the larger airways.¹⁶

Devices such as the TheraPEP® or Pari PEP are commonly used. During initial training, a physiotherapist may attach a manometer to the device to ensure the patient is generating the optimal pressure, typically between 10 and 20 cm H2O.²⁹ A session usually involves performing 10-15 breaths through the device, followed by huffing and coughing to clear the mobilised secretions.²⁹

The Flutter Valve (Oscillating PEP)

The Flutter is a specific type of PEP device that adds another therapeutic element: high-frequency oscillation.⁹ This small, pipe-shaped device contains a stainless-steel ball resting in a circular cone.³² As the patient exhales through the Flutter, their breath lifts the steel ball, which then falls back down with gravity. This process repeats rapidly, causing the ball to oscillate (or "flutter").³¹

This oscillation creates two effects simultaneously:

Positive Expiratory Pressure: Like a standard PEP device, the resistance from the ball creates back pressure to keep airways open.
Vibrations: The rapid fluttering of the ball sends vibrations down into the airways. These vibrations act to loosen stubborn mucus from the airway walls, making it easier to move.³³

The patient can alter the angle of the device to change the frequency of the vibrations, finding the position that gives the strongest sensation in their chest.³³ Other devices, such as the Acapella® and Aerobika®, work on a similar principle of oscillating PEP but use different internal mechanisms and are often not dependent on gravity, meaning they can be used in any position.¹⁵

The following table provides a concise summary of these key techniques, offering an at-a-glance reference to help understand their distinct mechanisms and applications.

Technique	Primary Mechanism	Best Suited For	How It's Performed
Postural Drainage	Uses gravity to drain mucus from specific lung segments towards central airways.	Clearing mucus that is localised in a particular area of the lung.	Passive; requires positioning assistance from a therapist or carer.
Percussion	Uses rhythmic, cupped-hand clapping on the chest wall to transmit kinetic energy and mechanically dislodge mucus.	Loosening thick, stubborn, and adherent mucus from airway walls.	Assisted by a therapist or carer; often combined with postural drainage.
Vibration	Applies a fine, shaking pressure to the chest wall during exhalation to gently mobilise secretions.	Moving loosened mucus into larger airways; often used for patients who find percussion uncomfortable.	Assisted by a therapist or carer; follows percussion.
Active Cycle of Breathing (ACBT)	A three-phase cycle of breathing control, deep breathing (thoracic expansion), and huffing (FET).	A structured, flexible, and independent method for daily airway clearance and breathlessness control.	Performed independently by the patient after instruction.
Positive Expiratory Pressure (PEP)	Creates positive back pressure during exhalation to splint airways open and get air behind mucus.	Patients with collapsible or "floppy" airways; promoting independent airway clearance.	Independent use with a handheld device (e.g., TheraPEP®).
Flutter Valve (Oscillating PEP)	Combines positive expiratory pressure with high-frequency airway oscillations (vibrations).	Loosening highly viscous or sticky mucus that is difficult to clear with other methods.	Independent use with a handheld device (e.g., Flutter®, Acapella®).

Chest Physiotherapy Treatment in Practice

girl at a physiotherapy clinic

Understanding the individual techniques is the first step; seeing how they are integrated into a cohesive physiotherapy treatment plan within the UK healthcare system provides a complete picture of their value. From the initial consultation to managing specific clinical scenarios, respiratory physiotherapy offers a practical, evidence-based pathway to better asthma control.

What to Expect from a UK Respiratory Physiotherapy Appointment

For many, the prospect of a new type of treatment can be daunting. A typical respiratory physiotherapy appointment in the UK, whether through the NHS or in a private clinic, follows a structured and patient-centred process designed to be reassuring and collaborative.

The initial assessment is comprehensive and usually lasts up to one hour.³⁶ The physiotherapist will begin by taking a detailed history, asking questions about your specific breathing problems, how they affect your daily life, your medical history, current medications (it is helpful to bring a list), and what you hope to achieve with treatment.³⁸ This is followed by a physical examination, which may include:

Observation: Looking at your posture and how you breathe at rest.³⁷
Auscultation: Listening to your chest with a stethoscope to identify areas of mucus build-up or wheezing.³⁷
Movement Assessment: The physiotherapist may feel for movement by placing their hands on your chest and abdomen as you breathe.³⁸
Exercise Tolerance Test: You may be asked to perform a simple test, such as a timed walk, to assess your fitness level and how your breathing responds to exertion.³⁶

Based on this thorough assessment, the physiotherapist will work with you to establish a clear set of problems and goals. They will then develop a personalised treatment programme, teaching you the most appropriate techniques for your needs and ensuring you are confident in performing them independently at home.³⁹ Follow-up appointments are typically shorter and are used to review your progress, refine your technique, and advance your programme as your condition improves.³⁷

Specific UK Cases: When Chest Physiotherapy Has a Positive Effect

The benefits of chest physiotherapy are most clearly illustrated through real-world clinical scenarios that many people with asthma in the UK will recognise.

Scenario 1: Managing an Acute Flare-Up with a Chest Infection
A person with asthma contracts a common cold, which then develops into a chest infection. They experience an increase in coughing, producing thick, yellow phlegm that is difficult to clear, and their breathlessness worsens. In this situation, a respiratory physiotherapist would advise them to increase the frequency and intensity of their airway clearance routine. For instance, they might be instructed to perform their ACBT or use their PEP device three to four times a day instead of their usual once or twice.15 This proactive approach helps to clear the excess infected mucus from the lungs, which reduces the work of breathing, helps medication work more effectively, and can prevent the infection from progressing to pneumonia or requiring a hospital admission.18

Scenario 2: Improving Exercise Tolerance and Confidence
A teenager with asthma loves football but finds that running during a match consistently triggers coughing and wheezing, causing them to stop playing. This leads to frustration and a gradual avoidance of physical activity. A referral to a respiratory physiotherapist would involve an assessment of their breathing pattern during exertion.20 The physiotherapist would likely identify an inefficient upper-chest breathing pattern and teach them diaphragmatic and paced breathing techniques to use while running.42 They would also work together to create a graded exercise programme, starting with gentle activity and gradually increasing the intensity, to build cardiovascular fitness and confidence. This empowers the individual to participate fully in sports without fear, significantly improving their quality of life.6

Scenario 3: Paediatric Asthma Management in a UK Setting
At a specialist children's hospital in the UK, such as Great Ormond Street Hospital (GOSH), a young child hospitalised with a severe asthma attack is struggling to clear secretions from their lungs, putting them at risk of lung collapse (atelectasis).17 A paediatric physiotherapist uses age-appropriate, playful techniques to encourage airway clearance. Instead of formal exercises, they might use "blowing games," such as using a Bubble PEP device to blow bubbles in water, or blowing a cotton-wool ball across a table with a straw.17 This makes the treatment fun and engaging for the child while achieving the clinical goal of clearing mucus, potentially reducing the time they spend in hospital and preventing the need for more invasive interventions.17

The Broader Scope of Modern Physiotherapy: Contextualising Advanced Modalities

A comprehensive physiotherapy plan is holistic, addressing the whole person and their unique set of challenges. While the core of asthma management focuses on the techniques described above, a physiotherapist's toolkit includes other advanced modalities. It is crucial, however, to understand their specific applications to maintain clinical accuracy and trust.

Electro Therapy (NMES): Neuromuscular Electrical Stimulation (NMES) is a form of electro therapy where electrical impulses are delivered via skin electrodes to stimulate muscle contraction.⁴³ It is important to state clearly that NMES is not a standard treatment for clearing mucus or treating airway inflammation in asthma. Its evidence-based role in respiratory care, supported by UK bodies like NICE and extensive Cochrane reviews, is for strengthening peripheral muscles (most commonly the thigh muscles).⁴³ It is used for patients with other chronic respiratory conditions, like severe COPD, or for individuals in intensive care who are so breathless or deconditioned that they cannot exercise in the conventional way.⁴³ By strengthening these muscles without causing significant shortness of breath, NMES can help improve a patient's overall functional capacity.⁴⁷
Shockwave Therapy: Extracorporeal shockwave therapy is a non-invasive modality that uses high-energy acoustic waves to treat various conditions.⁴⁸ Its primary and well-established use in physiotherapy is for musculoskeletal problems, particularly chronic tendinopathies such as plantar fasciitis or tennis elbow.⁴⁹ While emerging research has explored its potential anti-inflammatory effects in other areas, such as for lung inflammation in COVID-19 pneumonia,
shockwave therapy is not a recognised or recommended physiotherapy treatment for the management of asthma.⁵⁰ Mentioning these modalities demonstrates a comprehensive understanding of the physiotherapy field while responsibly clarifying their specific roles, which is essential for building patient trust and adhering to the principles of expertise and authoritativeness.

The Evidence: The UK's BREATHE Trial and a New Measure of Success

The value of physiotherapy-led breathing exercises for asthma is supported by high-quality evidence from within the UK. The BREATHE trial, a large randomised controlled trial led by the University of Southampton and funded by the National Institute for Health Research (NIHR), provides a landmark example.⁵¹

The trial investigated the effectiveness of a physiotherapy-based breathing retraining programme for adults whose asthma symptoms persisted despite standard medication.⁵² Participants were randomly assigned to one of three groups: one group received three face-to-face sessions with a respiratory physiotherapist, a second group received the same programme delivered via a self-guided DVD and booklet, and a third (control) group continued with their usual care.⁵¹

The results were compelling. Both the face-to-face and the digital programmes led to statistically significant improvements in the participants' asthma-related quality of life compared to the usual care group.⁵² The most crucial finding, however, was how this success was measured. The primary outcome was not a traditional lung function test like FEV1 (Forced Expiratory Volume in 1 second). Instead, it was the Asthma Quality of Life Questionnaire (AQLQ), a validated tool that measures how patients feel and function in their daily lives. The trial found that while AQLQ scores improved dramatically, there were no significant changes in objective physiological measures like FEV1 or markers of airway inflammation.⁵¹

This finding signals a vital paradigm shift in how the success of asthma management can be viewed. It proves that physiotherapy provides a powerful technique for coping better with the consequences of asthma, reducing the daily burden of the disease and improving well-being, even if it doesn't alter the underlying biology. It validates the patient's subjective experience as a critical clinical endpoint. The goal of modern asthma care, therefore, should not be limited to "improving the numbers" on a lung function test, but must also embrace the equally important goal of "improving the patient's life"—a philosophy that lies at the very heart of physiotherapy. Furthermore, the study demonstrated that these programmes were highly cost-effective, particularly the digital version, highlighting their potential for wider implementation across the NHS.⁵¹

Conclusion: Taking Control of Your Breathing with Physiotherapy

Asthma is a complex and often challenging long-term condition, but it does not have to dictate the boundaries of your life. While medication is essential for controlling airway inflammation, the integration of chest physiotherapy into a comprehensive management plan offers a proven, non-pharmacological pathway to better health, greater confidence, and an improved quality of life.

A Summary of Benefits: A Healthier, More Active Life with Asthma

The evidence and clinical experience outlined in this guide demonstrate the multifaceted benefits of a specialised physiotherapy programme for individuals with asthma. By engaging in a tailored plan, patients can achieve:

Improved Symptom Control: Effectively clearing mucus from the airways reduces coughing and chest tightness, while breathing retraining techniques help to manage and lessen the sensation of breathlessness.¹¹
Reduced Risk of Exacerbations: Proactive airway clearance can help prevent the build-up of secretions that leads to chest infections, reducing the frequency of flare-ups and the need for hospitalisation.¹¹
Enhanced Physical Capacity: Learning to control breathing during activity can break the cycle of exercise avoidance, allowing individuals to improve their fitness, stamina, and participation in the activities they enjoy.⁶
Greater Well-being and Quality of Life: As demonstrated by major UK studies, the ultimate benefit of these techniques is a significant improvement in how people feel day-to-day. Gaining control over breathing reduces anxiety and empowers individuals with the skills for effective self-management.¹¹

The Path Forward: Your Personalised Asthma Management Plan

The journey to better breathing begins with understanding the options available. The techniques of chest physiotherapy, from manual methods to modern device-assisted strategies, provide a rich toolkit for managing asthma. However, the most effective approach is one that is tailored to your specific needs, symptoms, and lifestyle. The crucial next step is a personalised assessment with a qualified respiratory physiotherapist who can diagnose your specific breathing challenges and co-create a sustainable and effective management plan.⁶ By working with a specialist, you can develop a robust self-management strategy and gain the skills and confidence needed to live well with asthma, all through the power of personalized physiotherapy.

Frequently Asked Questions: Chest Physiotherapy for Asthma

How can I get a referral for respiratory physiotherapy on the NHS?

You can request a referral to respiratory physiotherapy through your GP, asthma nurse, or respiratory consultant. Some NHS trusts also offer self-referral options for physiotherapy services, though availability varies by region.

What are the typical costs of private respiratory physiotherapy in the UK?

Private respiratory physiotherapy sessions typically cost between £45-£80 per session, with initial assessments often priced higher (£60-£100). Many private health insurance plans cover respiratory physiotherapy when medically necessary.

Can chest physiotherapy replace my asthma medication?

No, chest physiotherapy is designed to complement, not replace, prescribed asthma medications such as inhalers and preventers. Always continue taking your prescribed medication while incorporating physiotherapy techniques into your management plan.

Is chest physiotherapy suitable for children with asthma?

Yes, paediatric respiratory physiotherapists use age-appropriate, play-based techniques like bubble PEP and blowing games to make airway clearance fun and engaging for children with asthma. Techniques are adapted to suit the child's developmental stage and ability.

How long does it typically take to see results from chest physiotherapy?

Many people report improvements in symptom management and breathing control within 2-4 weeks of regular practice, though significant quality of life improvements may take 8-12 weeks of consistent application of the techniques.

Can chest physiotherapy techniques be used during an acute asthma attack?

No, during an acute asthma attack, follow your personal asthma action plan and use your reliever inhaler rather than attempting airway clearance techniques. Breathing control techniques can be used after initial medication has started working to help regain control.

How often will I need to attend physiotherapy sessions for asthma management?

After an initial assessment, most people require 2-4 follow-up sessions over several months, with the emphasis on learning techniques to practice independently at home. More complex cases may need more frequent or ongoing sessions.

Is respiratory physiotherapy beneficial for all asthma severity levels?

Yes, respiratory physiotherapy can benefit people with mild, moderate, or severe asthma, though the specific techniques and focus may differ. Even those with well-controlled asthma can improve their breathing efficiency and exercise tolerance through physiotherapy.

How can I find a qualified respiratory physiotherapist in my area?

Search for respiratory physiotherapists through the Association of Chartered Physiotherapists in Respiratory Care (ACPRC) or the Chartered Society of Physiotherapy (CSP) websites. Ensure they have specialized training in respiratory conditions and are HCPC registered.

Are breathing exercises for asthma different from general breathing exercises?

Yes, asthma-specific breathing exercises focus on addressing the particular challenges of airway narrowing and mucus build-up, while general breathing exercises may focus more on relaxation or stress management without addressing the specific physiology of asthma.

Can chest physiotherapy help with vocal cord dysfunction often misdiagnosed as asthma?

Yes, respiratory physiotherapists are skilled at treating breathing pattern disorders and vocal cord dysfunction through specialized breathing retraining techniques that focus on laryngeal (throat) control and reducing upper chest breathing patterns.

How does chest physiotherapy for pregnant women with asthma differ?

Physiotherapy for pregnant asthmatics emphasizes positions that accommodate the growing baby, focuses on non-pharmacological symptom management, and includes modified techniques that are safe during each trimester. Breathing exercises can also help manage pregnancy-related breathlessness alongside asthma symptoms.

Can chest physiotherapy specifically help with exercise-induced asthma?

Yes, physiotherapists can teach specific pre-exercise breathing techniques, warm-up strategies, and controlled breathing during activity to reduce the likelihood of exercise-induced bronchoconstriction. They can create personalized exercise programs that gradually build tolerance to activity.

Do I need special equipment to practice chest physiotherapy techniques at home?

While many breathing exercises require no equipment, some airway clearance techniques use affordable devices like Flutter valves or PEP devices (£30-£60) that your physiotherapist can recommend based on your specific needs.

Is respiratory physiotherapy covered by private health insurance in the UK?

Most UK private health insurance providers cover respiratory physiotherapy when medically necessary and referred by a doctor, but coverage limits, excess payments, and pre-authorization requirements vary between policies. Check with your insurer before booking.