Subjective and objective physiotherapy assessment for a patient with large airway collapse (LAC)
| Subjective: Patient's description/report | Objective: Physiotherapist's observations/measurements | ||
| A: Airways | |||
| NASAL SYMPTOMS Blocked or runny nose Sinus pain Post-nasal drip Altered sense of smell AIRWAY CLEARANCE Technique completed Frequency and length of Rx Efficacy % adherence | COUGH Effectiveness/ease of clearance Triggers Dry/rattling/productive Feeling of airway closure SPUTUM Colour/consistency 24-h volume | NASAL SYMPTOMS Quality of secretions Throat clearing AIRWAY CLEARANCE Observed technique Impact of airway closure on clearance Observed effectiveness | COUGH Nature/sound, e.g. barking/honking sound SPUTUM Viscosity/colour of sputum Microbiology |
| B: Breathing | |||
| BREATHLESSNESS Symptoms Triggers Recovery techniques | VOICE/UA Voice changes, e.g. husky/strained/lost voice Closure/discomfort in throat BREATHING PATTERN Awareness of breathing pattern | BREATHLESSNESS Work of breathing Upper limb fixation Accessory muscle use SpO2 Auscultation | VOICE/UA Audible upper airway sounds Quality BREATHING PATTERN Completion of BPAT score -Upper chest versus lower chest -Nose–mouth breathing -Flow/air hunger/RR/rhythm |
| C: Capacity for exercise | |||
| EXERCISE ABILITY Frequency of exercise Intensity of exercise Time spent on exercise Type of exercise Symptoms with exercise -cough/airway closure General physical activity levels Barriers to exercise Use of oxygen/NIV/CPAP for exercise | EXERCISE TESTING 6MWT 1 min STS Ax with and without CPAP/NIV Cough/SOB/WOB/SpO2 Breathing pattern changes during exercise UA SYMPTOMS Observed adaptations to breathing Audible airway collapse | ||
| Other Ax | |||
| SLEEP Quality/duration Epworth sleep score NIV/CPAP history +/− use | OUTCOME MEASURES VAS: ease of clearance/airway closure Dyspnoea-12 BPAT MRC grading Leicester cough questionnaire (LCQ) | ||
Rx: treatment; SpO2: oxygen saturation measured by pulse oximetry; Ax: assessment; UA: upper airway; NIV: noninvasive ventilation; CPAP: continuous positive airways pressure; RR: respiratory rate; SOB: shortness of breath; 6MWT: 6-min walk test; 1 min STS: 1-min sit-to-stand test; BPAT: breathing pattern assessment tool; WOB: work of breathing; VAS: visual analogue scale; MRC: Medical Research Council.