What is Postural Drainage?

Postural drainage or chest physical therapy is a useful method of accelerating drainage of fluid or mucus from the lungs when lung infection or illness is present. It involves placing the ill person in different postures for set periods of time, so that fluid from different parts of the lungs can drain. The specific amount of postures used can range from three or four to up to ten, depending on doctor recommendations. Very often, this technique also involves percussion (hitting the chest firmly but not too hard with a curved hand) or vibration (shaking the chest for a few seconds with an open palm) to help loosen mucus. People can use postural drainage at home, either on themselves, which is harder, or to treat others, but they do need instruction to perform it correctly.

Nurses, doctors or respiratory therapists may instruct people on how to perform postural drainage and percussion or vibration when it is needed. Conditions like pneumonia, bronchiolitis, or chronic respiratory illnesses such as cystic fibrosis might indicate its use. If these techniques require frequent use, some extra equipment might be necessary in the home setting. A few postures involve keeping the head below the rest of the body, and a table that tilts might be employed for this. If percussion is used, some people prefer to use rubberized devices, which are somewhat similar in appearance to suction cups with handles.

As mentioned, the number of postures recommended in postural drainage can vary. Complete drainage can involve as many as ten postures so that each area of the lungs is given a chance to clear more readily. Some of these positions include sitting upright or with the head leaning forward, lying on the back or stomach, and lying on the side with the head below the chest so that either the shoulder blade, chest or back are most exposed. A variety of pillows can help make positioning more comfortable. When percussion is used, it lasts for about five minutes and it is employed in specific places with each posture. If all ten positions are used, this therapy could take anywhere from 30-60 minutes to complete.

While many people may find postural drainage therapy helpful for promoting lung clearance, one noted side effect is stomach upset. Very young children sometimes get nauseous when this is done, and people with regular bouts indigestion or acid reflux may be significantly affected. Making certain that it has been a minimum of one-and-a-half to two hours after a meal may help avoid nausea or vomiting. If stomach symptoms aren’t resolved with this measure, it’s recommended that patients talk with doctors about alternative treatments to chest physical therapy.