In this guide
Respiratory physiotherapy helps clear congested airways and makes breathing easier. It is for babies and children as well as adults and older people, often after an infection, an operation or with a long-term lung condition. At home, the patient doesn’t have to go out when they are tired or frail, and the physio works in their own surroundings: their bed, their armchair, the rhythm of their day.
Who is respiratory physiotherapy for?
It is prescribed by a doctor (paediatrician, family doctor or lung specialist), who decides whether it will help and how many sessions are needed. It is often suggested:
- for adults with a long-term lung condition, such as COPD (chronic bronchitis), bronchiectasis or cystic fibrosis;
- after pneumonia, a chest infection or a hospital stay that has tired their breathing;
- after chest or abdominal surgery, to keep the lungs from congesting;
- for older or bedridden people who find it hard to cough and clear phlegm;
- for some children and babies, when the doctor finds it useful.
For babies and children
For babies, respiratory physiotherapy is no longer done routinely for bronchiolitis: current guidelines keep it for certain cases, and it is the doctor’s decision. What helps most day to day is clearing the nose well with saline before feeds and sleep, offering drinks often in small amounts, and watching their breathing.
When it is prescribed, the techniques are gentle and suited to the child’s age. The session is best done away from meals, so the child doesn’t vomit. The physio also shows parents how to clear the nose and which signs should worry them.
What the physio does in a session
The physio starts by listening to the breathing and watching how the patient coughs, gets out of breath and tires. They may then:
- help loosen and bring up secretions, with slow, controlled breathing out and guided coughing techniques;
- teach better breathing: from the belly, more slowly, breathing out through pursed lips to be less breathless;
- keep the chest supple and the breathing muscles strong;
- get the patient moving again step by step while watching their breath: standing, walking, climbing a few stairs;
- advise on good positions for sleeping and resting;
- show the patient and family the exercises to repeat between sessions.
What a home session looks like
A session usually lasts 20 to 45 minutes. All it takes is a bed or armchair where the patient is comfortable, tissues and a little water to drink. The pace is set with the doctor: sometimes several sessions close together during an infection, then sessions further apart for a long-term condition.
If the patient has oxygen at home or uses an inhaler, tell the physio: they adapt the session and may time the exercises after the inhaler, when the airways are more open.
Signs that mean calling for help
In a baby: very fast or noisy breathing, ribs pulling in with each breath, pauses in breathing, blue lips, a baby who is very tired or drinks less than half their feeds, or fever in a baby under 3 months. In an adult: severe breathlessness at rest, blue lips or nails, chest pain, blood in the phlegm or confusion. In these cases, call emergency services at once (15 or 141) or go to the emergency department. Don’t wait for the physio session.
Reimbursement
When prescribed by a doctor, respiratory physiotherapy can be covered by AMO (CNSS or CNOPS) or your insurer, depending on your cover. You need the prescription and a care sheet filled in by the physio. On Kinezy, physios who provide one say so on their profile.
This guide gives general information. It doesn’t replace the advice of your doctor or physio, who know your situation.