Introduction

• Coupage is a manual and mechanical 'chest physiotherapy' technique used in the treatment of specific respiratory patients to loosen retained airway secretions and improve mucociliary transport velocity.
• Generally used in conjunction with other physiotherapy techniques such as postural drainage and vibrations.
• The technique of coupage can also be used as a form of percussion massage to muscles to improve circulation and sensory stimulation. This latter effect is particularly useful as a form of therapy for flaccid muscles following neurological injury (lower motor neuron lesions) as it stimulates muscle activity via the muscle spindles.
  Print off the owner factsheet on Coupage to give to your client.

Chest physiotherapy

The technique of coupage

Adjuncts to coupage

Chest physiotherapy regime

Benefits and concerns of chest physiotherapy

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• McCool F D & Rosen M J (2006) Nonpharmacologic airway clearance therapies: ACCP evidence-based clinical practice guidelines. Chest 129 (1 Suppl), 250S-259S PubMed.
• Dunning D, Haling K B & Ehrhart N (2005) Rehabilitation of medical and acute care patients. Vet Clin North Am Small Anim Pract 35 (6), 1411-1426 PubMed.
• Levine D, Millis D L, Marcellin-Little D J et al (2005) Rehabilitation and physical therapy. Vet Clin North Am Small Anim Pract 35 (6), 1247-1517 VetMedResource.
• Stiller K (2000) Physiotherapy in intensive care: towards an evidence-based practice. Chest 118 (6), 1801-1813 PubMed.
• Manning A M, Ellis D R & Rush J (1997) Physical therapy for critically ill veterinary patients. Part 1. Chest physical therapy. Compend Contin Educ Pract Vet 19 (6), 675-689 VetMedResource.
• Stiller K, Geake T, Taylor J et al (1990) Acute lobar atelectasis: A comparison of two chest physiotherapy regimens. Chest 98 (6), 1336-1340 PubMed.
• Zidulka A, Chrome J F, Wight D W et al (1989) Clapping or percussion causes atelectasis in dogs and influences gas exchange. J Appl Physiol 66 (2), 2833-2838 PubMed.
• Mazzocco M C, Owens G R, Kirilloff L H et al (1985) Chest percussion and postural drainage in patients with bronchiectasis. Chest 88 (3), 360-363 PubMed.
• Connors A F Jr., Hammon W E, Martin R J et al (1980) Chest physical therapy. The immediate effect on oxygenation in acutely ill patients. Chest 78 (4), 559-564 PubMed.

Other sources of information

• Sharp B J (2008) Physiotherapy and rehabilitation. In: BSAVA Manual of Canine and Feline Advanced Veterinary Nursing, 2nd Ed. Hotson Moore A and Rudd S (eds). Gloucester: BSAVA Publications, 72-102.
• Nicholson H (2007) Respiratory physiotherapy. In: Animal Physiotherapy. McGowan C, Goff L and Stubbs N (eds). Oxford: Blackwell, 224-227.
• Millis D L, Levine D and Taylor R A (2004) Canine rehabilitation and physical therapy. St Louis: Saunders.
• Manning A M (2004) Physical rehabilitation for the critically injured veterinary patient. In: Canine rehabilitation and physical therapy. Millis DA, Levine D and Taylor RA (eds). Philadelphia: Saunders, 404-410.