Postural Drainage

Chapter 22


Postural Drainage






Preferred Practice Patterns


The most relevant practice patterns for the diagnoses discussed in this chapter, based on the American Physical Therapy Association’s Guide to Physical Therapist Practice, second edition, are as follows:



Please refer to Appendix A for a complete list of the preferred practice patterns, as individual patient conditions are highly variable and other practice patterns may be applicable.


Postural drainage is the positioning of a patient with an involved lung segment such that gravity has a maximal effect of facilitating the drainage of bronchopulmonary secretions from the tracheobronchial tree.1 The validity of postural drainage (with or without breathing exercises and chest wall manipulation) has been scrutinized in the literature over the past years, and the evidence is unequivocal. However, the use of postural drainage as an adjunct to other airway clearance techniques (ACTs) such as percussion, active cycle of breathing, autogenic drainage, oscillatory positive expiratory pressure (PEP), high-frequency chest compression, and exercise is recommended for patients with cystic fibrosis.2



Contraindications and Considerations


The physical therapist should note that there are many clinical contraindications and considerations for postural drainage.


The relative contraindications for the use of the Trendelenburg position (placing the head of the bed in a downward position) include the following3:



The relative contraindications for the reverse Trendelenburg position (placing the head of the bed in an upward position) include the following3:



The following are absolute and relative contraindications for postural drainage3:


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Jul 18, 2016 | Posted by in MANUAL THERAPIST | Comments Off on Postural Drainage

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