Percussion and Vibration guide

What is the Percussion and Vibration Technique?

Percussion and Vibrations are techniques to help patients clear mucus build up. It applies forces within the chest to aid the patient’s own secretion clearance mechanisms. It can be provided short term by your therapist.

If there is a long term need it will be taught to a carer. Items required to perform this technique include a towel, tissues and possibly bed and pillows.

How are Percussion and Vibrations used?

Physiotherapy aims to allow patients to self manage their condition. However, sometimes very thick secretions, weakness, or patient inability to cooperate means a manual technique can be used to assist.

Percussion and Vibrations combined with other physiotherapy techniques helps to move secretions to where they can easily be coughed and cleared, allowing air to re-enter areas of lung tissue previously
blocked by mucus further re-opening the lungs.

Cystic fibrosis, COPD, asthma, lung disease with secretory problems and patients with atelectasis (lung collapse) are some of the typical patients that would benefit from percussion and vibrations.

What does the technique involve?

If required your physiotherapist will advise the carer and patient how to provide percussion and vibrations using the method below.

Percussion - Cup hands

Position the patient in the following position:

1. Place a thick folded towel over the area you will be percussing.
2. Bend the fingers at the knuckles.
3. Press thumb against the side of the index finger forming a cup with your hand. (See pictures above).
4. Rhythmically move the arms from the elbows with relaxed wrists.
5. Compress air under the hand. Ensure you are not using the flat of the hand.

Vibrations

1. Place flat hands on the chest wall and try not to dig your finger ends in.
2. Vibrate applying pressure on the chest in the direction it naturally moves when the patient breathes out, you can use body weight to assist. Be gentle with the frail.
3. If the patient can, combine the vibrations with huffing and coughing.
4. The aim of percussion and vibrations  is to knock/shake secretions centrally to allow for easier clearance.
5. Percussion and vibrations can be combined with other treatments such as breathing exercises or the Acapella.

Note - Stop treatment if:

• the patient is diagnosed with osteoporosis, rib fractures or lung cancer
• there is blood in the sputum, chest shortness of breath seek medical advice.

Treatment cycle and how often?

Cycle

1. Three to five minutes of percussions.
2. As required vibrations.
3. Repeat steps one and two, three times.
4. Change position.
5. Repeat the process an agreed number of times daily.

How Often?

• if the patient is unwell, has an active chest infection, excessive or difficult to clear secretions, the number of treatment sessions may need to be increased
• if treatment makes the patient excessively tired, reduce the treatment time and instead increase the number of treatment sessions.

Relaxed Breathing to Aid Recovery

Test Your Breathing

Place one hand on your upper chest and one hand on your stomach, just below your ribs. You will probably feel your top hand move more than your bottom hand as you take a breath in.

This is an ineffective way of breathing when recovering from percussion and vibrations, you should be tummy breathing.

How to Tummy Breathe when recovering from Percussion and Vibrations

Breathe in slowly through your nose then out through the mouth. Aim to make your stomach rise as you breathe in and fall as you breathe out.

The aim is to relax your breathing. Try to slightly reduce the depth and rate of your breathing to reduce recovery time. It is very difficult to change your breathing pattern, however, if you practice daily it will
become more natural.

Huff

Take a slow half breathe in through your nose. Feel your lower chest expand. Open your mouth wide to make a big O with your lips and blow the air out through your open mouth. Practice by steaming up the mirror.

Our patients matter

Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and LiaisonService (PALS) and Complaints Team.

Telephone: 0151 471 2377 Freephone: 0800 328 2941 Email: palsandcomplaints@merseycare.nhs.uk