According to the Cystic Fibrosis Foundation, there are seven major airway clearance techniques (ACTs) for patients with lung disease. Airway clearance is needed to help clear away mucus from the lungs to help prevent infections and to improve lung function. Children will need an adult to assist with ACTs, and different pulmonary fibrosis (PF) patients will prefer different methods of airway clearance.

Coughing and Huffing
Coughing is one of the easiest airway clearance techniques and helps to release mucus which can then be deposited in a tissue and disposed of. Huffing is similar to coughing although not as forceful. It’s useful if you become tired from coughing.

Active Cycle of Breathing Technique (ACBT)
ACBT uses different breathing techniques that can be adapted to suit your needs. Active cycle of breathing works by getting air behind the mucus and forcing it out and includes controlled breathing, chest expansion exercises and forced expiration — which usually consists of huffs of varying lengths and controlled breathing.

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Autogenic Drainage (AD)
Autogenic drainage helps to move the mucus from the smaller airways to the larger ones. It is done by varying breathing speeds and inhaling to different levels and adjusting the exhaled breath. Because AD takes practice to perfect the technique, it is not usually recommended for children under the age of 8.

Chest Physical Therapy (CPT)
Chest physical therapy is also known as Postural Drainage and Percussion (PDP) and requires the patients to get into different positions so that the mucus can drain from the lungs. This is then followed up by the percussion of the chest — where the chest is clapped and vibrated to help move the mucus.

High-Frequency Oscillating Vest
This inflatable vibrating vest helps the dislodge mucus and move it into the larger airways. The vest is used in conjunction with huffing to release mucus.

Positive Expiratory Pressure (PEP)
This form of therapy is used to help open up the smaller airways with air pressure. The PEP treatment uses a mouthpiece or mask attached to a resistor and the patient is instructed to breathe in normally but to expel the air with more force than they usually would, helping to push the mucus out.

Oscillating Positive Expiratory Pressure (OPEP)
A treatment in which patients fully exhale the air in their lungs through an oscillating PEP device which vibrates both the large and smaller airways. The procedure is repeated many times and then patients cough or huff to extract the mucus.

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