Physiotherapists can help you manage your CF. It's not just about airway clearance, although that is an important factor.

Airway clearance

People with CF should do self-administrated clearance techniques every day, and your physio can help with teaching the technique that is best suited to you and your lifestyle.  This may include using a device to help with clearance such as PEP or an Acapella™.  However, manual techniques are also useful when you have an infection and the physiotherapist will be involved in these situations.

Some of the common types of airway clearance are listed below

Postural drainage & percussion 

The person is placed in a variety of positions which encourages mucus to drain from different parts of the lung. Chest clapping, or percussion, is added, along with deep breathing exercises, huffing and coughing to help clear mucus from the airway. Usually someone else is needed to help you with this treatment.

Active cycle of breathing technique (ACBT)

This is a cycle of breathing control, chest expansion exercises, and huffing. Breathing control and chest expansion exercises allow air to travel deep into the lungs and get behind thick mucus, which can then be coughed up by huffing.

Positive expiratory pressure (PEP)

PEP involves breathing out against resistance through a face mask or mouth piece. The resistance causes pressure to build up inside the lungs which stops the small breathing tubes collapsing. This allows air to get behind any mucus plugs and push them into a large airway where they can be coughed up.  There are different types of PEP devices. The ones we use most commonly are shown below.


Acapella ​



Regular exercise is important to keep yourself well.  There is evidence that  decreased aerobic fitness and decreased muscle power, strength and endurance affects lung function.

Your physiotherapist is here to help  all of this by assessing and giving appropriate advice. Exercise testing, such as the 6 Minute Walk Test, is a tool we use for determining exercise capacity or limitation.

Musculo-skeletal issues

postures.jpgSome people with CF can develop aches and pains due to poor posture and decreased flexibility. Back, shoulder, neck pain and headaches can develop because of poor posture related to coughing.  Your physiotherapist can help you learn to correct your posture, and teach you how to maintain a good posture when coughing. 

Other issues

Advice on pelvic floor function is also an important area for CF, due to the repeated force with coughing. A weak pelvic floor means you can get leaking of urine from the bladder when you cough. The physiotherapist can assess and educate on bladder or bowel dysfunction.

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Page last reviewed: 05 September 2013