title: [Chest physical therapy of the distal lung. Mechanical basis of a new paradigm].
abstract: Recent medical literature has shown that there has been renewed interest focused on the small airways deep in the lung tissue. Although there is involvement of the distal airways at an early stage in mucus secreting lung diseases, no specific chest physical therapy (CPT) manoeuver has been proposed for small airways clearance. A four-tier classification of CPT has been established with identification of its benefits at each level of a monoalveolar respiratory tract model. The usual expiratory techniques directed towards the upper and middle respiratory tract are not applicable to the small airways and new paradigm is proposed appropriate to their specific mechanical characteristics. This comprises a slow resistive inspiratory manoeuver in the lateral position. Clinical auscultation of the lung is the cornerstone of the validation and follow-up of the technique.
authors.affiliation: Groupe d'étude pluridisciplinaire, service des soins intensifs - site Notre-Dame (GHDC), Haute École Condorcet - Hainaut, section kinésithérapie, Grand Hôpital de Charleroi, Charleroi, Belgique. Electronic address: guy.postiaux@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Postiaux
mesh_terms: D006801:Humans; D008168:Lung / Q000502:physiology*; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000628:therapy*; D008962:Models, Theoretical; D026201:Musculoskeletal Manipulations / Q000379:methods; D026741:Physical Therapy Modalities / Q000145:classification; D012123:Pulmonary Ventilation / Q000502:physiology; D015656:Respiratory Mechanics / Q000502:physiology*; D013909:Thorax
keywords: Chest physical therapy; Deep lung; Décubitus latéral; Inspiratory resistance; Kinésithérapie; Lateral position; Poumon profond; Résistance inspiratoire; Small airways; Voies aériennes distales