Pulmonary Fibrosis (PF) is a lung disease that occurs when lung tissue becomes damaged and scarred, leading to breathing difficulties. There is no cure for PF, but physiotherapy can help manage symptoms, improve quality of life, and slow down the progression of the disease.

Before starting physiotherapy, a thorough assessment is required to determine the patient’s physical status, functional abilities, and limitations. This assessment can include:

• Measurement of lung function: This includes spirometry, which measures the amount and speed of air that a patient can exhale.
• Assessment of breathing pattern: This can be done by observing the patient’s breathing rate and pattern, and assessing their use of accessory muscles.
• Assessment of exercise capacity: This can be done through walking tests or cycle ergometry.
• Assessment of strength: This can be done through muscle strength testing.

Physiotherapy treatments for PF

Breathing exercises – Breathing exercises can help improve the function of the respiratory muscles and increase oxygen intake. The following types of breathing exercises may be used:

• Diaphragmatic breathing: This involves breathing from the diaphragm instead of the chest, which can help improve the efficiency of breathing.
• Pursed lip breathing: This involves exhaling through pursed lips, which can help slow down breathing and reduce breathlessness.
• Deep breathing exercises: This involves taking deep breaths to increase oxygen intake and improve lung function.

Airway clearance techniques – Airway clearance techniques can help remove mucus from the lungs and airways, making it easier for patients to breathe. The following techniques may be used:

• Chest percussion: This involves tapping the chest with cupped hands to help loosen mucus in the lungs.
• Postural drainage: This involves positioning the patient in specific positions to help drain mucus from different parts of the lungs.
• Active cycle of breathing technique (ACBT): This involves a combination of breathing control, deep breathing, and huffing to help loosen and clear mucus.
• Oscillating positive expiratory pressure (OPEP) devices: These devices create resistance when patients exhale, helping to vibrate the airways and loosen mucus.

Exercise training – Exercise training can help improve the function of the respiratory muscles and increase exercise capacity. The following types of exercise training may be used:

• Aerobic exercise: This involves activities such as walking, cycling, or swimming to improve cardiovascular fitness.
• Resistance training: This involves exercises that target the muscles used for breathing, such as the diaphragm and intercostal muscles.
• Inspiratory muscle training: This involves exercises that strengthen the muscles used for inhaling.

Education and self-management – Education and self-management are important components of the treatment of PF. Patients can learn techniques to manage their symptoms and improve their quality of life. This can include:

• Understanding the disease and its progression
• Learning how to use inhalers and other medications correctly
• Understanding the importance of breathing exercises and airway clearance techniques and how to perform them correctly
• Learning how to manage breathlessness and anxiety
• Understanding the importance of a healthy diet and exercise