Examples include patients with Bronchiectasis COPD (chronic obstructive pulmonary disease), in certain clinical situations (2) Cystic fibrosis Neuromuscular disorders Pneumonias in dependent lung regions Contraindications Contraindications to chest physiotherapy all are relative and include the following: Bleeding diathesis (including therapeutic anticoagulation) Discomfort due to physical positions or manipulations Elevated intracranial pressure Recent hemoptysis Rib fractures Vertebral fractures or osteoporosis Procedure Chest physiotherapy may be administered by a respiratory therapist, although the techniques can often be taught to family members of patients.