Cardiopulmonary Physiotherapy
What you must understand
Know normal and abnormal breath sounds, breathing patterns, and the mechanics of airway clearance. Understand indications, contraindications, and sequencing of techniques: postural drainage, percussion, vibration, active cycle of breathing technique, autogenic drainage, positive expiratory pressure devices, and incentive spirometry. Know exercise prescription principles for cardiac and pulmonary rehabilitation, including the Borg scale, six-minute walk test, and contraindications to exercise (unstable angina, uncontrolled arrhythmia, severe desaturation). Understand oxygen therapy principles and the importance of monitoring vital signs.
Traps in questions
- Performing percussion or postural drainage without considering haemoptysis, osteoporosis, or recent rib fracture.
- Using incentive spirometry as an airway clearance technique rather than a lung expansion tool.
- Ignoring desaturation or Borg score thresholds when progressing exercise.
- Confusing obstructive (prolonged expiration, pursed-lip breathing) with restrictive patterns.
Rule of thumb
For secretion retention, choose the technique that matches the patient's effort, cognition, and secretion location; always position for ventilation-perfusion advantage and monitor tolerance. For exercise, start at a level that keeps symptoms within agreed thresholds and titrate.
Worked example
A postoperative patient with shallow breathing and basal atelectasis but no excess secretions needs lung expansion (deep breathing, incentive spirometry, early mobilisation), not percussion and drainage.