Exacerbations in lung conditions implies a worsening of respiratory symptoms  that is beyond normal day-to-day variations.

Frequent exacerbations have been demonstrated to have a negative impact on quality of life in patients with respiratory conditions.  Furthermore, acute exacerbations are the most frequent cause of medical visits, hospital admissions, prolonged hospitalization  and increased mortality rates among patients with chronic lung conditions. Some of these respiratory conditions include:

What causes Exacerbations of previous lung conditions?

Some of these factors may be the recognised risk factors for relapse:

  • Increasing age
  • Active smokers
  • Severity of the underlying condition – severely impaired FEV1 (lung function test)
  • Comorbid conditions such as diabetes or significant cardiac disease such as heart failure
  • Respiratory infection (atypical microorganisms and viruses)such as influenza, rhinovirus, haemophilus influenza and streptococcus pneumoniae)
  • Environmental factors such as low temperature and air pollution
  • Alcohol consumption
  • Presence of chronic mucus hypersecretion
  • Types of pathogenic bacteria colonising in the airways such as pseudomonas
  • Unknown aetiology (cause)
  • Frequent number of past exacerbations 

What are the symptoms of an exacerbation?

The symptoms include worsening of your usual symptoms of your condition.

Please see individual conditions for more details on symptoms.

Management of an exacerbation


Frequency and severity of exacerbations may be reduced using the aforementioned strategies:

  • patient education
  • smoking cessation
  • influenza and pneumococcal immunisation
  •  pulmonary rehabilitation (exercise therapy) 

Medical Intervention

Early recognition of worsening  symptoms is vital to gain medical intervention as soon as possible if required. This may be a visit to your GP or hospitalization.

Pharmacological Management

This may include the following depending on the severity of the exacerbation:

  • Inhalers
  • Antibiotics
  • corticosteroids

Non-Pharmacological management

This may include:

  • Respiratory physiotherapy
  • Oxygen therapy
  • NonInvasive Ventilation

What would physiotherapy treatment for exacerbations of lung conditions involve?

At Respiratory Physiotherapy Ireland, Our physiotherapists will ensure you receive specialised treatment for your exacerbation. Depending on the severity and duration of your exacerbation, your treatment may involve:

  • Secretion clearance:
    • Active Cycle of Breathing
    • Autogenic Drainage
    • Positive Expiratory Pressure (PEP)
    • Oscillating positive expiratory pressure
    • Effective / productive coughing techniques.
    • Postural drainage in sitting and lying.
    • Manual techniques, including percussion and vibrations
  • Breathing techniques:
    • Controlling respiratory rate
    • Diaphragmatic breathing
    • Relaxation breathing exercises
  • Education and Advice:
    • Illness cause and progression.
    • Effects of environmental and allergen factors, including smoking.
    • Medication management
  • Exercise Assessment and Prescription
    • Those experiencing dyspnoea on exertion (even mild dyspnoea) may benefit from a formal exercise program. A formal exercise program generally includes aerobic and resistance training. Exercise training includes intensity, frequency, duration, type, mode and progression based on the severity and type of COPD.

It will be important to note that the respiratory physiotherapy we apply should be closely incorporated with other health care professional’s management of the client’s needs.


After exacerbation, it takes a considerable time for respiratory compromised patients to recover to baseline functional status, which is defined as an individual’s ability to perform the normal daily activities required to meet basic needs, fulfil usual roles, and maintain health and well-being. Quality of life (QOL) deteriorates in patients who experience exacerbations, and the more frequent the exacerbations, the more rapid the decline in QOL. However, with proper management of your exacerbation, most people can achieve good symptom control and quality of life.

Respiratory physiotherapy can provide a key role in managing your exacerbation to help with sputum clearance, reduce work of breathing associated with your respiratory condition and restore patient’s maximal function and improve muscle weakness.

Here at respiratory Physiotherapy Ireland, we can apply a range of therapy techniques and advice to manage your symptoms and maintain the best possible level of lung function and comfort. We can also advise on activity modification to make daily living easier. Along with advice for you and your family on appropriate self-management techniques to maximise your functional ability between therapy sessions.

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+353 86 105 5791

+353 86 105 5791

Have any questions?
Call us now!