Active cycle of breathing techniques (ACBT)An airway clearance technique. A cycle of the techniques of breathing control (BC), thoracic expansion exercises (TEE) and the forced expiration technique (FET).
Air flowExpressed volume/time (l/min).
Air flow velocityExpressed distance/time (m/min), speed.
Airway clearance technique (ACT)An airway clearance strategy (with or without a device) used to support mucus clearance by loosening, mobilising, transporting and evacuating airway mucus.
Assisted autogenic drainage (AAD)Autogenic drainage (AD) carried out with assistance in infants, toddlers or individuals unable to follow instructions or to participate actively.
Autogenic drainage (AD)An airway clearance technique utilising optimal expiratory flow rate at different lung volume levels.
Bilevel positive airway pressure (BiPAP)Assisted ventilation with independent settings for positive inspiratory and expiratory pressures.
The “Bird”See Intermittent positive pressure breathing.
Blow-as-you-go!A term to help remind the patient to exhale on effort, stretching and bending to improve respiratory mechanics during activity.
Bottle-blowing/bubble PEP“Positive expiratory pressure” generated by blowing through a narrow tube into water.
Breathing control (BC)Normal tidal breathing encouraging relaxation of the upper chest and shoulders.
Breathing exercisesExercises designed to alter breathing for a particular purpose—for example, increasing lung volumes, decreasing lung volumes, airway clearance.
Buteyko breathing technique (BBT)A compilation of “reduced breathing” exercises and other strategies for control of asthma symptoms; it is a more intensive and broader therapy than the conventional physiotherapy technique but with similar results.
Chest clapping/percussionRhythmical percussion (tapping) of the chest wall using either the hand(s) with a flexion/extension action of the wrist(s) or a mechanical device, with the aim of loosening secretions.
Chest compressionFirm manual or mechanical compression of the chest during expiration in the direction of the normal expiratory movement of the ribs—that is, down and in to enhance “air flow” or “cough peak flow”. Commonly combined with “chest shaking/vibrations” to enhance airway clearance. Can be used as a “manually assisted cough” technique.
Chest mobility exercise(s)Physical flexibility exercises to maintain or increase the mobility of the chest wall.
Chest physiotherapyHistorical ambiguous term used to define airway clearance therapy. Commonly in the USA refers to “postural drainage” with “percussion”, with or without “chest compression”.
Chest shaking/vibrationsShaking or vibrating the chest wall during expiration, in the direction of rib movement; usually combined with “chest compression”
Continuous positive airway pressure (CPAP)Assisted ventilation with the same positive pressure setting during the whole breathing cycle.
Cough techniqueUsing cough in a controlled way, at specific lung volumes, to check for and/or assist the removal of bronchial secretions.
Cough controlBeing able to control the cough, to prevent unproductive paroxysms of coughing or coughing attacks.
Delta rollator frameA triangular “rollator frame”; highly manoeuvrable and may have a carrying bag attached for ambulatory oxygen.
Diaphragmatic breathingBreathing using abdominal movement; reducing the degree of chest wall movement as much as possible. Not advocated in patients with hyperinflation. Commonly used in complementary therapies.
Directed coughingCoughing under instruction; direction given on technique, timing, frequency and duration
Energy conservation (EC)A method of performing tasks and activities to utilise breathing, pacing and positional strategies to reduce the work of a task/activity.
Expiratory muscle training (EMT)Breathing out against a resistance as a means of enhancing strength or endurance of the expiratory muscles. Can be against a fixed load or via a threshold load resistor.
Expiratory resistance breathing (ERB)Breathing out against a resistance. Type and size of resistance chosen dependent on physiological strategy, aims and individual needs. May be used for, for example, airway clearance or “respiratory muscle training”.
Forced expiration technique (FET)Huffs/forced expirations interspersed with periods of “breathing control”.
Forward lean sitting (FLS)Seated, leaning forwards, relaxed; supporting the elbows on either a table or own knees. Enhances respiratory muscle function by loading the diaphragm and by passive fixation of the shoulder girdle. Commonly used where there is hyperinflation of the lungs and increased FRC, as in COPD.
Glossopharyngeal breathing (GPB) (frog breathing)A method of breathing using the tongue and soft palate (as a frog does) to push air into the lungs for enhancing inspiration in an individual with weak inspiratory muscles.
Gutter rollator frameA “rollator frame” with a shoulder height support for the forearms; used for severely breathless patients to allow mobility which otherwise is very difficult.
High-frequency chest wall oscillator/oscillation (HFCWO)A device/technique to oscillate the chest wall externally by means of a pneumatic jacket to aid loosening of secretions.
High positive expiratory pressure (Hi-PEP)An airway clearance technique combining “positive expiratory pressure” with forced expirations against the resistor.
Huff, huffingA huff is a forced expiration with an open glottis; when performed from a large lung volume moves central secretions; from a mid lung volume moves peripheral secretions.
HumidificationAdding moisture to inhaled air or oxygen to prevent drying of mucosa and/or secretions and to improve gas exchange; may be sterile water or normal saline via nebuliser chambers, both large and small volume and via a heated water bath.
Hypertonic saline (HTS)A solution of (commonly 7% in the UK but may be 9%) saline to increase fluid flux from the airways into the mucus to improve secretion clearance; usually advocated preairway clearance
Inhalation deviceA device through which aerosolised or powdered drugs can be inhaled.
Inhalation therapyDelivery of aerosolised or powdered drugs to the airways through inhalation.
Inspiratory muscle training (IMT)Breathing in against a resistance as a means of enhancing strength or endurance of the inspiratory muscles. Can be against a fixed load or via a threshold load resistor.
Intermittent positive pressure breathing (IPPB)The original form of “NIV”; pressure cycled, powered by compressed gas with an integral nebuliser; flow rate, sensitivity and pressure are adjustable. Mouthpiece is the most commonly used interface but may be delivered via a port-free mask (without a fixed leak), as closed circuit system.
Intrapulmonary percussive ventilation (IPV)A device to oscillate/percuss the chest internally to aid loosening of secretions, by means of high-frequency bursts of gas. Powered by compressed gas and can be used to deliver nebulised drugs during treatment.
Manually assisted cough (MAC)Firm compression of the chest wall or abdomen during expiration to enhance a weak cough in an individual with weak/paralysed expiratory muscles. Often combined with a “maximum insufflation capacity” technique.
Manual techniquesThe collective term for chest compression, chest shaking and chest wall vibrations; see individual techniques.
Manual therapyThe treatment of joints and muscles by specific mobilisation, manipulation and stretching.
Maximum insufflation capacity (MIC)Enhancing inspiration prior to a cough in an individual with weak inspiratory muscles; via “chest compression”, “NIV”, “IPPB”, a bag or “glossopharyngeal breathing”. Commonly used with a “manually assisted cough”.
Mechanical in-exsufflation (MI-E)A device to provide both positive and negative pressure in alternating cycles to enhance “MIC” and/or “cough peak flow” to enhance airway clearance. Can be combined with other techniques, most commonly a “manually assisted cough” technique.
Modified postural drainageThe adaptation of “postural drainage”—that is to eliminate head-down positions.
Mucociliary clearanceThe physiological movement of airway mucus by the mucociliary transport system, in a cephalad direction (towards the mouth).
NebuliserA device that aerosolises a liquid.
Nebuliser systemEquipment comprising an energy source and a nebuliser. These function as a unit.
Nijmegen QuestionnaireA self-complete tool for measuring symptoms of hyperventilation.
Non-invasive ventilation (NIV)Assisted ventilation applied non-invasively via a mask or mouthpiece for spontaneously breathing patients.
Oscillating positive expiratory pressure (OscPEP)An airway clearance technique which utilises the effects of oscillating “positive expiratory pressure” and oscillating flow, combined with cough or “FET”.
Paced breathingBreathing to a rhythm—for example, in time with walking or stairs, to help maintain control of breathing and thereby reduce dyspnoea.
Peak cough flow (PCF)The peak flow an individual can generate with a cough through a peak flow meter. Used to gauge cough effectiveness in individuals with respiratory muscle weakness.
PercussionSee “Chest clapping/percussion”.
Physical activityUsed to influence breathing pattern, ventilation and ventilation distribution, and to preserve physical function and flexibility; sports, activities of daily living (ADL), etc.
Physical exerciseTargeted exercise(s) to preserve/improve a specific physical function.
Physical trainingA prescribed programme of physical exercise to improve/maintain exercise capacity and endurance, mobility, muscle strength and posture.
PositioningThe use of different body positions to maintain joint and/or soft tissue length; improve the mechanics of breathing; utilise the effects of gravity to facilitate drainage of bronchial secretions; stimulate both skeletal and smooth muscle postural tone; and increase regional ventilation and/or perfusion.
Positive expiratory pressure (PEP)An airway clearance technique which utilises the effects of tidal volume breathing towards an expiratory resistance, combined with FET or cough.
Postural drainage (PD)The use of gravity for drainage of secretions guided by bronchial anatomy.
Pursed lips breathing (PLB)The generation of a positive pressure within the airways by expiration against partially closed lips, as in whistling.
Reduced breathingA technique using smaller than usual tidal volume and/or lower respiratory rate and increasing relaxation; used for patients with hyperventilation syndrome or stable asthma for control of symptoms; also a key part of the “Buteyko breathing technique”.
Respiratory muscle training (RMT)Breathing in or out against a resistance as a means of enhancing strength or endurance of the inspiratory or expiratory muscles, respectively. Can be against a fixed load or via a threshold load resistor.
Reverse Trendelenburg positionSupine position without flexing or extending, with the head higher than the feet.
Rib-springingA term used to describe a form of “chest compression” with overpressure at the end of expiration to enhance inspiration via stretch reflexes in individuals with weak inspiratory muscles or unable to cooperate.
Rollator frameA walking frame with wheels back and front for ease of use by breathless patients as it allows fixation of the shoulder girdle.
Self-percussionPerforming “Chest clapping/percussion” independently.
ShakingSee “Chest shaking/vibrations”.
Slow, deep breathingA technique used during exertion/exercise to help maintain control of breathing and reduce dyspnoea in tachypnoeic patients.
Thoracic expansion exercise (TEE) (deep breathing)Deep inspiration towards inspiratory capacity; the independent means of achieving “MIC”.
VibrationsSee “Chest shaking/vibrations”.
Visual analogue scaleAn arbritrary linear score of 10 cm to represent the range of possible symptom perception.
Trendelenburg positionSupine position with the feet higher than the head.