Respiratory Diseases

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If the client has an inhaler, it should be readily available during the massage treatment in case the client needs it. *— Triggers for asthma or allergies are important to know so that the therapist can try to avoid exposing the client to these triggers. *— Clients with sleep apnea or other breathing difficulties might need extra pillows or bolsters to increase client comfort. If signs of edema are found, the therapist should always ascertain the cause of the edema before proceeding. Postural deviations and the client’s style of breathing can help the therapist decide on which muscles to focus treatment. *— The therapist should listen for the following respiratory-related sounds: high-pitched sounds, wheezing, rattling, crackling, and deep or harsh sounds. Wheezing indicates narrowed respiratory passages, and crackling or rattling can indicate excess mucus in airways. What can breathing through the mouth indicate? Breathing through the mouth generally indicates the presence of constrictions or blockages in air passageways (such as when a person has a cold). Massage therapists should be familiar with the medications used to treat respiratory disorders and the medications’ associated side effects. *— Clients who use inhalers should also be sure to have the inhaler available during their massage. Which medications are inhalers generally used to administer? Inhalers are generally used to administer bronchodilators and mast cell stabilizers. These medications are generally used to prevent or treat the symptoms of asthma. Massage therapists should be aware of the general manifestations of respiratory disorders and refer clients with any of these signs to their respective health care providers. *— Rapid, difficult, prolonged, or labored breathing are breathing patterns that can indicate the presence of a respiratory disorder. *— What breathing sounds should therapists listen for? Breathing sounds to listen for include the following: high-pitched sounds; rattling sounds; deep, harsh sounds; and no breathing sounds. Apnea often occurs during sleep and is referred to as sleep apnea. Clients who have sleep apnea generally suffer from loud snoring, insomnia, sleepiness, headaches, and sometimes depression. *— The massage therapist should determine the cause of the apnea and adjust the massage accordingly, including adjusting the position of the client to maximize the client’s comfort. What benefits can a general, relaxing massage provide clients with apnea? Massage can help the client rejuvenate and possibly help alleviate symptoms of depression. What are some useful massage techniques for clients with asthma? The following techniques can be useful: deep friction; kneading; ischemic compression; deep, gliding strokes; vibration; and percussion. If the client has chronic bronchitis, a full-body relaxing massage is helpful. Postural drainage (placing the head lower than the rest of the body) can be useful for clearing mucus from the respiratory tract. Percussion and vibration on the ribcage can also be helpful. The common cold is an acute inflammation of the mucosa of the upper respiratory tract. Clients will be contagious 2 to 3 days after cold symptoms appear and should not be massaged during that time period. *— Once the symptoms are no longer acute, massage can be performed although it may exacerbate cold symptoms for a short time. *— What are the benefits of massage for clients with the common cold? Massage therapy decreases the overall recovery time for the common cold. Cystic fibrosis is a genetic disorder that causes thick mucus to obstruct the airways. *— If clearance is obtained for massage, what techniques and positions should be used? The client should be positioned so that the head is lower than the rest of the body to promote clearing the respiratory tract of mucus. Percussion and vibration on the ribcage can be helpful. The massage should focus on the muscles of respiration using deep friction, kneading, ischemic compression, and deep gliding strokes. The difficulty in exhaling will cause the muscles of respiration to be especially tight. What are the secondary muscles of respiration? The secondary muscles of respiration include the following: the sternocleidomastoid, the intercostals, the scalenes, and the pectoralis minor. The semireclining position for clients with emphysema can help them breathe more easily. *— What massage techniques can be useful for clients who have emphysema? The following techniques can be useful: deep gliding, deep friction, kneading, and ischemic compression. However, a gentler massage might be required if the client tires easily. If the allergic attack is not acute, what positions and techniques should be used when performing massage on clients with hay fever? The therapist needs to ask the client if lying prone and/or using the face cradle is comfortable because these positions can help nasal passages to drain. General massage is indicated, but the therapist should ensure that the treatment area is free of dust and allergens. What is the most serious complication of influenza? Bronchopneumonia is the most serious complication of influenza. *— Massage is contraindicated because influenza is a contagious disease and because massage would only exacerbate the symptoms. If the cause of laryngitis is not due to an infectious disease, then general massage can be performed if the pleurisy is not caused by a bacterial infection, then what massage techniques should be used? The massage treatment should focus on the primary and secondary muscles of respiration, using the following techniques: deep friction, ischemic compression, and deep gliding strokes. What are some other types of pneumoconiosis and what are they caused by? Silicosis is caused by silica; welder’s lung is caused by iron oxide; and coal worker’s pneumoconiosis is caused by coal dust. *— If clearance for massage is obtained, then a general, relaxing massage involving ribcage vibration and percussion is recommended. The therapist should also keep tissues readily available because the client is likely to cough as a natural reflex. *— What should the massage focus on? The massage should focus on the primary and secondary muscles of respiration, using the following techniques: deep friction, kneading, ischemic compression, and deep gliding strokes. Pneumonia is the most common infectious cause of death in the United States. What groups of people are most susceptible to pneumonia? Older adults, infants, immunocompromised individuals, and cigarette smokers are most vulnerable to pneumonia. *— If clearance is obtained, then the massage should focus on the primary and secondary muscles of respiration, using deep friction, kneading, ischemic compression, and deep gliding strokes. Stretching and joint mobilizations can help prevent muscle atrophy due to prolonged bed rest. Pulmonary edema also involves excessive amounts of interstitial fluid in lung tissue. The figure on the slide shows the effects of pulmonary edema due to congestive heart failure. What are some other common causes of pulmonary edema? Some other common causes of pulmonary edema include near drowning, renal failure, cerebrovascular accidents, and infection. *— If the symptoms are less severe and clearance is obtained from the client’s health care provider, then a shorter, lighter massage is indicated. A pulmonary embolism is caused by an embolus blocking off the pulmonary artery or one of its branches. What is an embolus? An embolus is a blood clot, bubble of air, or any piece of debris transported by the bloodstream. *— Why is massage contraindicated? Clients experiencing a pulmonary embolism require immediate medical attention, so they should not receive massage. What are some symptoms of RDS? Respiratory distress syndrome is characterized by a high respiration rate (more than 60 breaths per minute) and nasal flaring. *— Why is massage contraindicated? Adults and infants with RDS are very debilitated, so massage is contraindicated for this life-threatening disorder. Because individuals with SARS will be very debilitated, massage is contraindicated. Why is massage contraindicated if the client has a fever? Massage is contraindicated for clients who have fevers because massage increases blood flow, which only exacerbates the symptoms and makes the client feel worse. If the client does not have a fever, then general massage can be performed. What massage techniques are useful for clients with sinusitis? Local moist heat applications and deep ischemic pressure applied over the frontal and sphenoidal sinuses can help to relieve pain. The inhalation of steam can help the client relieve congestion. When is the client no longer infective? Generally, 2 to 4 weeks after the start of medication treatment, the client is no longer infective, but this should be determined by the client’s health care provider.

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