[Can respiratory kinesitherapy palliate the functional sequelae of chronic obstructive bronchopathies?]

Certain physiotherapy techniques can actively contribute to alter the functional consequences of chronic airflow obstruction (hyperinflation, respiratory rhythm and limitation of expiratory flow). Postural drainage does not seem useful until the secretions exceed 30 ml/24 hours. A search for a comfortable body position will no doubt offer mechanical and/or muscular advantages to the patient's breathing. Expiration with pursed lips slows the respiratory rate and limits airway collapse on expiration. Breathing at low frequency improves gas exchange but increases muscular work particularly if the physiological end tidal volume is exceeded. The rules of respiratory physiotherapists should in practice be modified to suit each individual patient.