Conventional chest physiotherapy includes postural drainage, percussion,
chest shaking, huffing and coughing. Recently, several
new physiotherapy techniques have been developed, including the
active cycle of breathing techniques, positive expiratory pressure
and osteopathic manipulative treatment. Active cycle of breathing
techniques include active breathing control, thoracic expansion
exercises and forced expiration technique, and sometimes postural
drainage and chest clapping. Positive expiratory pressure uses devices
to provide a positive expiratory pressure of 10 to 25 cmH20
during expiration. It may stabilise airways by keeping them open
during expiration, which may facilitate airway clearance. Osteopathic
manipulative treatment includes bilateral paraspinal inhibition,
bilateral rib raising, diaphragmatic myofascial release and
soft myofascial release to the anterior thoracic inlet. It may improve
chest wall mobility and enhance exercise tolerance.