Objective assessment
A comprehensive objective assessment will assist with the prescription of an appropriate, individualised management plan.
It can include:
Test results
Radiology – HRCT, CXR – see Radiology
Lung function tests – see Lung Function
Pathology – sputum, blood – see Sputum Pathology
Vital signs
SpO2, heart rate, respiratory rate
Auscultation
Cough
Effectiveness of the cough
Sound – moist, dry, upper or lower airway closure
Paroxysmal cough
*Breathing pattern
Nose/mouth
Upper chest/lower chest
Vocal cord dysfunction
Respiratory rate
Mobility/Musculoskeletal
Spinal and thoracic cage mobility
Posture – fixed or habitual
Pain – location, intensity, affect on airway clearance and exercise
Gait – aids required
Exercise tolerance – see Exercise Prescription
Observation of techniques
Medication devices – MDI and spacer, accuhaler, turbuhaler, other
Current therapies – eg ACBT, flutter, PEP device
*Breathing pattern disorders are common in people with bronchiectasis as a slow, deep breath will often trigger a cough and nose breathing (which is important for the humidification and filtration of air) can often be difficult due to sinus issues. When chronic hyperventilation is suspected, the Nijmegen Questionnaire is a useful assessment tool and objective measure.
The Breathing Dysfunction video demonstrates the basic assessment and management of breathing dysfunction in people with chronic respiratory conditions
It is important to educate the patient in the importance of an appropriate breathing pattern.
An example of a – Bronchiectasis Physiotherapy Assessment Form
An example of a patient completed assessment form – Bronchiectasis Out-Patient Registration form
