Physiotherapy at home with Mum

Question

Guillaume, young CF patient, almost 12, is no longer able to do a good physio with a Physiotherapist in private practice. Does he have to do his Physio with his mother in the room where other parents and children are, when he is invited?

Answer

Dear e.corn user,
Your question is a double one, isn’t it ? Does Guillaume have to do his physiotherapy with his mother, as he no more likes to do it with a Physiotherapist? Does Guillaume have to do his physio in the room where other people are?
1.Does Guillaume have to (or can) do his physiotherapy with his mother?
The answer is “Yes. “Physiotherapy” for Guillaume is a set of techniques applied, practiced and taught by a physiotherapist. It can be done without the presence of a physiotherapist, when Guillaume knows how to make one. As part of a chronic respiratory disease, the patient must be able to practice anytime, 24/24. The physiotherapist teaches and accompanies learning. In the case of a child, parents are also invited to learn techniques in order to participate in their child’s learning.
In the case of an adult, we enhance the training of the person close to the patient and to encourage the “coach” as we say today.
2. Does Guillaume can do his physiotherapy in front of other people?
Let’s focus on respiratory physiotherapy. As there are other items in the physiotherapy’s program for Guillaume (physical activities, relaxations, stretching, muscle strengthening, breathing exercises and rehabilitation).
With regard to chest physiotherapy, the maneuvers of opening the upper airways (nose washing, snoozing) and bronchial tree (wheezing, crakles, cough, sputum production generate noise and can be embarrassing for Guillaume or other people.

When the mucus is infected, coughing and splitting throw small droplets infected within about 2 meters.
Guillaume and his mother follow preventive rules of hygiene before, during and after the session (hand washing, wearing a gown, possibly a mask for Mum, cleaning surfaces that may have receive projections of saliva in cough).
Proximity to other people during these maneuvers is not desirable, especially children, frail persons, to avoid infection transmission.
If Guillaume and his mother can not have another room to perform chest physiotherapy session, which would be the best option, they need to be away from other people, Guillaume turned back to prevent any germs and saliva exposure. In this case, it is necessary for Guillaume to agree and feel comfortable doing his exercises in presence of persons other than his parents. It also requires that other people accept that. Another option would be that the persons leave the room the time of the session, then 15 to 20 minutes of ventilation of the room after the session.
Complementary response in relation to the situation of Guillaume:
Guillaume is less willing to make his chest physiotherapy session with a physiotherapist. During adolescence, young people can come into conflict with things established. May perceive the treatment of chest physiotherapy primarily as a “work imposed by adults” more than practicing techniques to preserve his health, prevent congestion and bronchial infections.
Coaching a young person with a chronic illness is taking data with him/her and help him/her understand what is happening, what happens when he/she does such this treatment or that activity, which is password if he/she does not. In France, the process of therapeutic education establishment in the CF Centers exists for several years. The aim is to improve the understanding and expertise of CF patients for their disease. We encourage Guillaume and his parents to talk about to the doctor after Guillaume in the CF Centre.

Claudine Lejosne

24.11.2011