Chest percussion combined with postural drainage, known as chest physical therapy (CPT), breaks up the congestion and uses gravity to help an individual remove it through coughing. CPT may be performed in the home by an individual or caregivers, or in a clinic or hospital by physical therapists, respiratory therapists, or nurses. High frequency chest wall percussion is a machine that delivers chest physiotherapy by means of pulsed pressure, helping the patient to mobilize airway secretions. This bronchial drainage system includes a vest connected to a pulse generator and enables patients to self-administer the technique of high frequency chest compression to assist with Chest physical therapy treatments applicable to patients in the ICU are discussed. Postural drainage, percussion, vibration, breathing exercises, cough stimulation techniques, and airway suctioning are described in detail, with current references. The importance of patient mobilization is emphasized. Chest physiotherapy consists of external mechanical maneuvers, such as chest percussion, postural drainage, and vibration, to augment mobilization and clearance of airway secretions. It is indicated for patients in whom cough is insufficient to clear thick, tenacious, copious, or loculated secretions ( 1 ). Examples include patients with. Mechanical percussion increases intra-thoracic pressure.15 But no studies have been performed to examine the effects of manual percussion. It has been hypothesized that the air trapped between the cupped hand and the chest wall creates a vibratory wave that is transmitted through the chest wall and loosens secretions attached to the airway Fig. 1 Correct hand position for manual chest percussion The rationale for the technique is that the application of force to the chest wall alters the intrapleural pressure. This pressure change is transmitted through to the lung tissue and assists in dislodging secretions from the airway wall. Cd increased significantly over time in the manual percussion (p = .042) and palm-cup percussion (p = .046) group, where Cd in the latter remained elevated twice longer than in the former. chest physiotherapy needs to be of 1 hour duration to be effective. To enhance the clearance of secretions, chest wall clapping or percussion was added to postural drainage. It is thought that percussion generates flow transients in airways beneath a percussed segment that improve the gas-liquid interactions.15 Suttonetal.16 demonstrated that Chest physiotherapy consists of external mechanical maneuvers, such as chest percussion, postural drainage, and vibration, to augment mobilization and clearance of airway secretions. It is indicated for patients in whom cough is insufficient to clear thick, tenacious, copious, or loculated secretions ( 1 ). Examples include patients with. Percussion is a manual technique used by respiratory physiotherapists to help clear the chest of secretions (phlegm). The physiotherapist will apply a rhythmical clapping motion upon the chest wall with a cupped hand to loosen the secretions from the sides of the lungs. The technique is applied over a towel to ensure it does not feel uncomfortable.