Assessment of the forced expiration technique, postural drainage and directed coughing in chest physiotherapy

The Forced Expiration Technique (FET), postural drainage (PD) and directed coughing have been evaluated in 10 patients with copious sputum (mean value 63.3 ml/24 h) with an inhaled radioaerosol method over a 30-min treatment period. FET alone and FET + PD (but not directed coughing) cleared more radioaerosol than during the control period (P less than 0.01). The wet weight of sputum obtained following FET, FET + PD and directed coughing were all significantly greater than control (P less than 0.01). However, sputum obtained by FET + PD was significantly greater than FET alone (P less than 0.05). Both FET and particularly FET + PD have been shown to be more effective than directed coughing alone and it is suggested that these manoeuvres should be incorporated into standard chest physiotherapy.