**5. Chest mobilization techniques**

Chest mobilization techniques are the original protocol used in chronic lung disease, which has the tendency to cause poor posture, rigidity, or lack of thoracic spine and rib cage movement (Vibekk, 1991). These techniques are divided into passive and active chest mobilization, which depends on the patient's condition. In the case of an unconscious patient, as seen in an intensive care unit (ICU) where prolonged treatment is carried out with or without ventilator support, the" **Passive Chest Mobilization Technique**" can be performed on the chest wall by a therapist. Whereas, in the case of a patient in recovery or good condition, the "**Active Chest Mobilization Technique**" can be performed. In some general practices, patients who have just recovered can have modified Active-Passive Chest Mobilization to improve flexibility of the chest wall. The aim of these techniques is to improve thoracic mobility at the upper, middle or lower parts of the chest. Furthermore, these techniques need to be selected carefully to minimize dyspnea, and they should be applied in sitting, sitting leaning forward or high side lying positions (Lee, 2002; Rodrigues & Watchie, 2010).

Fig. 11. Chest Mobilization Techniques for improving thoracic mobility at the postero-lateral parts (trunk rotation) (Vibekk, 1991) by active and passive trunk rotation on both sides. Exhalation in a forward position is carried out at the beginning of flexion, and rotation of the left side is performed laterally with inspiration. However, an exhalation phase is carried out during passive trunk rotation.
