Iscough aseffective aschest physiotherapy inthe removal ofexcessive tracheobronchial secretions

Therelative value ofchest physiotherapy (including cough) andcoughalone forthe removal ofexcessive tracheobronchial secretions hasbeenassessed insixpatients withstable chronic obstructive lungdisease. Afterlabelling withinhaled radioactive tracer particles, clearance of secretions fromselected central andperipheral lungregions was followed witha gamma camera linked toacomputer. Coughalone andchest physiotherapy (including cough) wereequally effective intheenhancement ofcentral lungclearance. Physiotherapy butnotcoughalone accelerated peri- pheral lungclearance (p< 005).Sputumyield was greater during physiotherapy thanduring cough(p< 0-05). Thesefindings confirm thevalue ofchest physiotherapy andhigh-light thelimita- tionofcoughinpatients withexcessive tracheobronchial secretion andimpaired mucociliary clearance.