Each client will have a routine specifically developed for them by their CF physiotherapist. The following is an example of a routine: Client should sit comfortably with a straight back and supported elbows. Device mouthpiece should be placed into the mouth between the teeth, with lips sealed firmly around the mouthpiece so no air can escape when breathing out. Instruct your client to breathe in slowly, through the nose, keeping their throat open, and hold for 2-3 seconds. Then they should breathe out actively (forced but not too forced) against the device aiming to keep cheeks stiff so that the vibrations occur in their chest and abdomen rather than their mouth – it may help if they hold their cheeks with their hand when they first start, or use their tummy muscles actively to control where the vibrations occur. Cycle is repeated for 10 -15 breaths. When breathing out, or exhaling, the client should aim to stop the exhalation before the point of uncontrolled coughing. Coughing should ideally be avoided until the mucus has moved to the upper airways. If mucus has reached the upper airways, your client can clear with huffing and an effective controlled cough. Their physiotherapist can guide them regarding the frequency and number of breaths or time of each session.
If your client experiences increased shortness of breath, a
new occurrence of chest pain, or coughs up any blood (haemoptysis) during the
treatment session they should stop the session and you should contact CFWA, or
the care team for further advice.
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