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Percussion

Date: July 2015

Review: July 2017

Ref Number: B-343/AS/Physiotherapy/Percussion

PDF:  Percussion [pdf] 201KB

This technique is also known as chest clapping, and is used to help loosen secretions and move the sputum (phlegm) inside of the chest so that it is easier to cough out. It is usually combined with Postural Drainage. Percussion is usually undertaken by a carer.

To perform percussion a cupped hand is used by to clap the chest firmly and rhythmically (over a layer of clothing or a towel).

Please refer to the video link on YouTube to follow the technique (PLYMOUTHNHSPHYSIO): Chest physiotherapy https://www.youtube.com/watch

Before the Percussion

  • It is best to do Percussion technique before meals or at least two hours after eating. This will make it less likely that you will feel sick to the stomach or throw up.
  • The best times for Percussion technique is early morning and before you go to bed at night. Early morning Percussion technique will help remove the sputum that built up over night. Bed time Percussion technique takes out the mucus of the day, and helps you cough less at night. You may want you to do it more often if advised by your Physiotherapist.
  • The person doing the Percussion should take off all rings and jewellery on the hands or wrists and wash their hands before and after the technique.
  • Avoid wearing tight clothing.
  • Place a towel on the area you want to percuss.
  • Gravity assisted positioning uses different body positions to help the drainage of secretions from particular areas of the lungs and also helps to increase the air movement or ventilation to different parts of the lungs.
  • Your physiotherapist may advise lying on either side, your front and back and sitting rather than specific positions.

The technique:

  • Lie in a side lying position. It can also be done in sitting position.
  • Always percuss over the ribs. The lungs are in the chest, protected by the ribs. Never percuss below the ribs, on the stomach, backbone, breast bone, nipples or on any tubes around the chest area or feeding tubes.
  • Percuss at the rate of 2-3 per second.
  • Do Percussion in each spot for 2 to 3 minutes.
  • Do Percussion in all positions so that you cover all areas of the lungs on both sides.
  • Your Physiotherapist may advise you do more in some areas, where there is evidence of more mucus.
  • One session of Percussion should take 20 to 30 minutes.
  • Try to suppress your cough.
  • Do a few more relaxed slow breaths.
  • Then huff as directed 1-2 times
  • Repeat this for 10-15 minutes in the position advised by your Physiotherapist or until you have cleared all your sputum.

If you have any adverse reaction such as coughing up blood, stop using the Percussion technique and seek medical advice.

Please use this technique only if assessed and advised by a Physiotherapist.

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