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Percussion and postural drainage

What is percussion and postural drainage?

Percussion and postural drainage is a chest physiotherapy technique to help clear mucus from the lungs. It includes: 

Postural drainage, which uses gravity in a few positions to help drain mucus from different areas of lung.

Percussion (patting), which is slow rhythmic clapping with a loose wrist and cupped hand. This creates an energy wave that is transmitted to the airways. The percussion helps to loosen secretions from the airway walls.

How do I do it?

Think of the chest being divided into a left side and a right side, for the left and right lungs.

The lungs come as far up as the collar bone and as far down as just above the bottom of the ribs.

A cupped hand is used to tap over the chest. Tuck your thumb into the side of your hand.

Photograph of someone's cupped hand with their thumb touch their first finger's first knuckle

Depending on the age of your child, you may be advised to adapt this hand position, for example using only 2 or 3 fingers for babies.

Keeping your hand position still, use your wrist to move your hand up and down over the appropriate area. You should pat firmly and rhythmically, so you can hear a hollow sound.

Try to do 2 sets of 30 pats over each lung (left and right), in each position. The whole session should take about 10 to 15 minutes.

Positions

There are 5 main positions used to drain mucus and encourage air into different areas of lung.

You will be told by your physiotherapist as to which positions you should focus on:

Lying on back

Pat over the front of the chest, remembering to split the chest up into left and right sides.

Photograph of baby laid on its back with someone placing their cupped hand on the baby's chestPhotograph of baby laid on its back with someone placing their cupped hand on the baby's chest

Side lying (left and right)

Pat over the upper most side of the chest.

Photograph of baby laid on its side with someone supporting it's neck, and using their other cupped hand to press onto the baby's side

Lying on stomach

Pat over the back side of the chest, again splitting the chest up into the left and right.

Photograph of baby laid on their front with someone supporting their neck and using their other cupped hand to press into their backPhotograph of baby laid on their front with someone supporting their neck and using their other cupped hand to press into their back

Upright sitting

You can pat the front of the chest or the back, it does not matter.

Photograph of someone with baby sat on their lap supporting them and using one cupped hand to press into their back Photograph of someone with baby sat on their lap supporting them and using one cupped hand to press into their back

Where do I do it?

If your child is young and relatively small, it may be easier to position them on your lap. When your child gets bigger you may wish to place them on a mat on the floor or on a bed and position yourself appropriately so you are comfortable.

How often do I do chest physiotherapy?

Do percussion times a day when your child is well.

You may be told to increase this to times a day when your child is unwell.

Information:

Do not do percussion on your child if they have eaten less than 45 minutes before, as they may be sick (vomit). If your child has reflux you may need to speak to your physiotherapist about the positions you use.

Contact us

If you have any question or concerns, please telephone cystic fibrosis physiotherapy on 0114 271 7273.

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Disclaimer

Please note this is a generic information sheet relating to care at Sheffield Children’s. The details in this resource may not necessarily reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If you have specific questions about how this resource relates to your child, please ask your doctor.

Resource number: CF10

Resource Type: Article

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United Kingdom

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