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Respiratory therapy

What do you do with respiratory therapy?

The respiratory therapist decides which methods are correct in each individual case, depending on the individual therapy goals. Basically, all exercises are first described by the therapist and possibly demonstrated. The patient imitates the exercise with the therapist providing assistance if necessary. If the patient feels a movement during breathing therapy as painful, it can also be reduced.

Respiratory therapy: exercises to improve mobility

Often therapists use so-called to improve mobility Twist-stretch layers a. The patient lies on his back on a sleeping mat and concentrates on individual parts of the body that lie directly on the mat - for example the back or the buttocks. Then he should relax completely and consciously "let himself sink".

Then the therapist leads the "lower rotational position“On: The patient stands up with his knees touching each other and lets his knees drop to the side. He places his arms bent over his head in a U-shape and turns his head in the opposite direction to his legs. Now the legs are tilted alternately to the right and left, whereby the trunk is stretched in the direction of the longitudinal axis of the thigh.

Another example is the so-called Quadruped. The patient gets into position on all fours on the floor (knees directly under the hips, hands directly under the shoulders). Now he makes a cat hump, so bends his spine upwards and lowers his chin towards his chest. Then the countermovement follows: the patient slowly and consciously pushes the sternum downwards and thus goes into the hollow back. The head is placed back slightly. The whole thing can be repeated several times. Variations are also possible, for example by not positioning the hands under the shoulders, but placing the fingertips on the floor directly in front of the supported knees in order to specifically train the thoracic spine area when bending and stretching the back. In another variant, instead of putting the palm of your hand, you put your forearms under your shoulders on the floor. In this exercise, the lumbar spine is mainly trained.

Respiratory therapy: exercises to improve breathing movement

In order to encourage breathing movement, the therapist helps the patient to consciously perceive his breathing movement. On the other hand, the patient actively trains the breathing movement when inhaling through:

  • repeated sniffing during the inhalation phase
  • breathing in slowly, deeply and holding your breath briefly
  • Blocking one nostril when you breathe in through your nose

Breathing out can also be positively influenced by breathing exercises. It helps to make the exhalation visible, for example by breathing against a mirror.

Exhalation is passively supported by so-called manual chest compression: Here, the patient lies in a supine position with his legs on the side on a therapy couch. The therapist places his hands on the chest and squeezes it gently but noticeably together as he exhales. The patient should feel the pressure, but not perceive it as strenuous or restrictive.

Respiratory therapy: exercises for the regulated breathing rhythm

To practice breathing evenly, help stretchingas they are also carried out in sport - for example free stretching of the whole body while standing. A breathing rhythm should be maintained during stretching and loosening in which the breath does not have to be held during any exercise phase.

Also passive stretching exercises with the therapist are possible: For example, the patient lies on his side on a therapy couch and bends his lower leg. The upper one is laid out stretched out on a pillow. The therapist grabs the inside of the knee and grips the ankle with the other hand. As soon as the patient inhales, the therapist stretches the calf muscles (the patient should remain relaxed). As you exhale, the stretch is relaxed. Arms, feet or hands can also be treated in this way.

Respiratory therapy: exercises to strengthen the respiratory muscles

To strengthen the muscle groups involved in inhalation, the patient lies on his stomach. The pressure of the abdominal organs on the diaphragm makes breathing more difficult and more work has to be done to be able to breathe deeply.

For easier exhalation, relaxed training of the abdominal muscles such as sit-ups or simply tensing the abdominal muscles while standing is recommended.

Respiratory therapy: exercises to cleanse and keep the airways open

In pneumonia or cystic fibrosis (cystic fibrosis), mucus and secretions collect in the airways and obstruct them. The respiratory therapy can be done here with different expectorant exercises To help. For example, when you breathe out you can hum “M” or exhale air at the sounds “P, T, K” so that the chest vibrates and the mucus loosens. It also has the same effect if the back is tapped firmly with the fingers over the affected sections of the lungs.

In order to keep the airways wide open and thus enable a good gas exchange, one is often enough breath-relieving body position:

  • Lie on your side with your upper body slightly raised
  • Sit with your arms propped backwards
  • Squat with your head propped up on your knees
  • Stand with your arms propped up
  • "Goalkeeper posture" (arms supported on thighs)

Respiratory therapy: exercises for relaxation

To relax and slow down breathing, the patient lies on his back and places his hands loosely on his stomach. As he breathes, he gently strokes his abdominal wall with his hands. The same thing works when you are seated, where your hands should be on your ribs. This technique is easy to do yourself.

Therapeutically guided exercises are, for example, shaking. The therapist grabs the patient's arm and raises it in a relaxed position. Then he pulls it lightly repeatedly and lets go again.

Reflective breathing therapy

In so-called reflective breathing therapy, the therapist makes use of the body's reaction to breathing exercises. The holistic therapeutic measure consists of three parts:

  • Application of heat
  • manual techniques
  • Breathing exercises

First, the therapist wraps hot towels around the arms or legs. This relaxes the muscles and prepares them for manual therapy, and stimulates blood flow and breathing. This is followed by so-called manual techniques: These are special physiotherapeutic grips that - similar to a massage - are intended to stretch the muscles and loosen the connective tissue. This is followed by breathing therapy exercises.

Respiratory therapy: exercises for emergencies

In order to counteract the collapse of the bronchi in the event of an asthma attack, patients learn what is known as the lip brake during breathing therapy: During an asthma attack, they exhale against the pointed, only slightly open mouth. As a result, the exhaled air is blocked in the lungs and pressure keeps the bronchi open.