Breathing exercises to clear lungs after pneumonia & COVID-19

hello everyone I'm Adam from new forest physiotherapy clinic I'm here with my assistant Rosie who happens to be my daughter as well now I've had a question from a patient about breathing exercises she was suffering from kovat 90 and she ended up in hospital requiring oxygen she was sent home after a couple of weeks but she wasn't given any breathing exercises I think that was in the early stages maybe the physios weren't yet so I'm covering the wards but she wanted some breathing exercises to help her recover and I think this would be useful for a lot of people who are recovering from kovat 19 or from pneumonia or a breathing problem that has blocked up their lungs that's important to understand the anatomy of their lungs and how we breathe before we start these exercises so we're only to do Rosie's make a fist with your right hand and just place it up against your chest now that fist represents your heart okay and if you all do that as well as you watch this now approximately where she's placed her fist there's where her heart is above it on the Left we have the left upper lobe on the opposite side we'd have the right upper low now the left lung doesn't have a middle right lobe because the heart sits where the middle lobe would be on the right side we do have a middle lobe okay if you just turn sideways on Rosie okay just lift your arm forward and I want you to imagine imaginary line coming up here and at the back here you have your lower lobe the lower lobe of the lungs are the largest lobe okay so on both sides you have the lower lobe generally when you get something like pneumonia it's the lower lobes that we need to get reinflates they're the ones that fill up with sputum and get blocked up which ends up reducing your oxygen level so that's why people end up having to have oxygen is because their lungs are full of sputum they can't use them for the alveoli the little air sacs where the oxygen goes into the blood and the caramel dioxide comes out it can't work because it's full of fluid okay so these lower lobes are the lobes we want to reinstate with breathing exercises just turn back around Rosie so we have different mechanisms for breathing the diaphragm is a muscle that kind of if you just pop your arms down is a muscle that kind of it's like a dome here kind of cuts us in half okay it separates the chest cavity from the abdominal cavity and that diaphragm when we breathe in using the diaphragm it kind of flattens down and it pushes the stomach out okay so we know when we're using the diaphragm because the ribs don't move but the stomach does move okay the other mechanism for breathing is the ribs so the ribs come round the body whew if you just turn around Rosie like so and we've got ribs going up and down the ribcage 12 ribs and as they lift up it basically causes the lungs to expand drawing air in and as they drop down it causes the lungs to deflate okay so we're going to start with Rosie is diaphragmatic breathing so if you just place your hand on your stomach here okay without moving the ribs and without moving the shoulders I want to take a deep breath in so as you breathe in your stomach pushes out okay and then out so you're breathing here into your diaphragm deep breath in and out good and again deep breath in and out okay that's good that's good diaphragmatic breathing if you just turn sideways on okay just turn back that way so they can see you just put that hand down put your right hand on your stomach okay and just try it again so breathing in to the stomach that's it so as she breathes in her stomach pushes out her ribs don't move okay deep breath in through your nose out through your mouth okay good I face that way so that's diaphragmatic expansion that's a really useful breathing technique to really get the the air into the bottom of your lungs okay now the other way to breathe is using your ribcage so I'm just going to put my hands Rosie on your ribs just to keep facing the camera here okay so as you breathe in your ribs are going to expand Rosie put your arms down so people can see okay so you breathe in through your nose expanding the ribs and out sit and again nice deep breath in and out okay keep the shoulders relaxed okay you want when you breathe if you don't want to hunch the shoulders you want to keep the shoulders nice and relaxed because what we don't want to do is just have the air coming just into the top of the lungs we want it to really sink down deep into the lower lobes of the lungs okay so just try that again deep breath in and out okay good and then do the diaphragm so breathing here so hopefully you can see the difference there once you breathe with the diaphragm the ribs don't move when she's breathing with the ribs her stomach doesn't move okay so there's two different breathing techniques Rosie's quite good at this usually people breathe with one method or the other and so they'll find one method easy and the other other one difficult but the best breathing really is with the diaphragm if you can master that that would be good okay so at this cycle of breathing technique is you're gonna do four deep breaths with a huff and a cough another four deep breaths with a half knock off and you could just continue cycle until you've cleared phlegm off of your chest okay so resi what are we to do we'll start with rib breathing I'm going to put my hands on your ribs so I want you to do four deep breaths with your ribs in through your nose out through your mouth nice deep breath nice deeper that's to relax the shoulders get the ribs moving three or more nice deep breaths and out okay with a hot so it's a big breath in do that good okay imagine you're steaming up a mirror okay and you're trying to get it nice and steamed up okay and that can help to just bring phlegm from in the bottom of the lung here up into higher up into the lungs what we want to do is clear the sputum from here and get it up into the larger Airways okay from the larger Airways it's easy to cough it out of your mouth and out of your lungs okay so that's what half of it now I want you to put your hand on your stomach and I want to do for deep breath since your stomach too three nice deep breath four and then do a big strong coffin to your hand so you don't spread everywhere okay so at this cycle you do four or five deep breaths into your ribs half cough four or five deep breaths in chest stomach half cough and you could just keep repeating that cycle until you clear some soot off your your chest so I'm going to demonstrate for you now a postural drainage technique to help drain phlegm and sputum out of the bottom lobe of the lungs what you need is four or five pillows on the floor like so and then you get your patient to lie over the pillows if you can lie over there rosy that's it okay so they're lying over what we call this a postural drainage position because the lower lobe of the lungs here at the back as I explained earlier with gravity now if there's any sputum in here that that sputum is going to be working its way down with gravity towards the larger Airways where rosy will be able to cough it out a lot more easily now we can encourage that sputum out of the lungs by doing something called percussion now to do that you need to cup your hands like so and you just on the on the back where the ribs are you just tap today now Rosie's wearing a thick jumper if she wasn't wearing a thick jumper you should take a towel and just put that over the person's back like so and just cup your hands I said now Rosie obviously she's only a child so I can do this with with one hand and I can cover a good portion of her lungs if your patients bigger again an adult basically you can do it two hands and you'll know if you're over the loans because it'll make a nice resonant sound but if you're not over the lungs it makes a different sort of sounds like a dull thud as opposed to sort of a hollow resonating sound if you could hear the difference there you hear the difference Rosie yeah it's just it's kind of a deeper but there was this resonant sound here so you could do this for 5-10 minutes probably you the person doing the treatment will be the one that gets tired out and we'll literally for cutting the sputum out of our lungs and as I said earlier most of the sputum will be in these lower lobes don't forget you do on both sides of the lungs and what you could do is get her every now and again to try Hough can just try Hough in that position Rosie so it's my goodness if you're stinging up a mirror and you could percuss while she's doing that [Music] see she sounded chesty he because her even that little bit I've done has helped to clear a bit of sputum you could hear a little bit there the other thing you can do is a bit of shaking so just take a deep breath in into my hands and out now she breathes out you just kind of shake the ribs and again deep breath in and also in this position can make sure she's expanding the lower lobes into your hands and again deep breath in nice deep breath rosy and nice deep breath into my hands Rosie and [Music] should be painful try cough don't feel quite weird okay so there's a breathing exercises and postural drainage tech needs to help clear the lungs now you would be careful with this percussion and shaking if you've got osteoporosis you could have brittle ribs so if you're an older person with osteoporosis and you'd be very cautious with this and if you someone who maybe gets headaches or has an increased intracranial pressure pressure inside the skull and tipping the head down will increase that so just be cautious of that if you you know if you've got any other major sort of medical conditions then you may need to check with your physiotherapist or your doctor whether or not you should be doing this but assuming you've got no other medical conditions other than you know recent pneumonia or kovat 19 which has caused pneumonia in the lungs then you should be fine with this kind of technique thank you hope you found that useful goodbye

Channel: Newforestphysio Southampton

Views: 622,793

Keywords: corona virus, covid 19, physio, physiotherapy, breathing@exercises, pneumonia

Id: DBuPbYjPpao

Length: 13min 8sec (788 seconds)

Published: Thu May 21 2020