Heart Encyclopedia
Chest Physiotherapy Treatment (CPT)

What is Chest Physiotherapy Treatment (CPT)?

The lungs make mucus to help defend against germs. Cystic fibrosis changes the mucus, making it thick and hard to clear. This mucus is where infections can occur. Infections cause inflammation or swelling of the lungs. Both infections and inflammation cause more mucus to be made. More mucus in the lungs can lead to more infections. This cycle of infection, inflammation and more mucus can hurt the lungs and lower lung function.

The cycle can hurt lung function.

Performing CPT

Brisk percussion of the chest wall helps to break up and dislodge mucus, so it can be more easily huffed or coughed out of the body.

  • The child is placed into different positions so that mucus can be more easily moved (see pictures below).
  • Different areas of the chest wall are percussed to help loosen and move the mucus toward the center of the chest.
  • Percussion is performed for two minutes in each different position.
  • Two to three huff coughs are performed between each position, if the child is old enough.
  • Repeat until all different positions are complete.

Tips for Percussion

1. Put a thin layer of clothing, such a T-shirt, on your child’s chest.

2. Use a cupped hand or percussor cup. If done right, you will hear a popping sound. Percussion should not cause red marks on your child.

3. Do not percuss over the backbone, breastbone, or lower two ribs.

4. Do CPT before meals or 30 minutes after meals.

5. Percuss on both the right and left sides.

6. Patient should get two treatments daily and increase to three to four when sick.

Positioning Your Child for Percussion

A respiratory therapist (RT) will show you how to do percussion. Do percussion on both right and left sides. If you have any questions, ask you child’s RT.

  • Sitting position
  • Slightly leaning back
  • Percuss over shoulders on both side
Chest Physiotherapy Pic 2


  • Sitting position
  • Slightly leaning forward
  • Percuss over shoulder blades on both sides

Chest Physiotherapy Pic 3

  • Lying flat on back
  • Percuss between shoulders and nipple on each side
Chest Physiotherapy Pic 4


  • On side, slightly tilted back
  • Percuss over nipple area or just below breast in females, on both sides
Chest Physiotherapy Pic 5


  • Lying on side
  • Percuss over lower ribs on both sides
Chest Physiotherapy Pic 6


  • Lying on side, whole body rolled slightly forward
  • Percuss over middle portion of the rib cage on both sides
Chest Physiotherapy Pic 7


  • Lying flat on stomach
  • Percuss over middle back on both sides
Chest Physiotherapy Pic 8


  • Lying flat on stomach
  • Percuss over lower back on both sides
Chest Physiotherapy Pic 9


Last Updated 03/2020

Reviewed By Carolina Sprinkle, RRT III, and Ginger Browning, RRT III

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