Physiotherapists usually use auscultation and chest radiography to assess the patient and monitor their intervention. But these outcome measures have a low accuracy. The use of lung ultrasound by the physiotherapist to evaluate respiratory conditions of the patient offers new perspectives such as define indications for chest physiotherapy, evaluate its efficacy and adjust treatment in real-time. The objective of this review is to present how ultrasounds can be used for lung and diaphragmatic assessment at the bedside and to propose possible applications in chest physiotherapy. Lung ultrasound enables diagnosis of pleural effusion, pneumonia, atelectasis, pulmonary contusion, pulmonary edema and pneumothorax with high sensitivity and specificity. Sonographic evaluation of the diaphragm enables to quantify its motion, thickness and contractility. Understanding the lung ultrasound fundamentals and basic signs allows an accurate assessment of pleura, lung parenchymal and diaphragm. Lung ultrasound assesses lung aeration disorders and can guide the physiotherapist’s choice of techniques and parameters in chest physiotherapy. It is also an excellent tool for pleural assessment and may be a way to clarify indication of chest physiotherapy in pleural effusion. Diaphragm sonography enables to highlight in real-time diaphragm response to all chest physiotherapy techniques that are intended for this purpose. The use of lung ultrasound by physiotherapist needs to acquire solid knowledge in anatomy, pulmonary physiopathology and lung ultrasound semiology. Rigorous training and experience are requirements for lung ultrasound use within chest physiotherapy decision tree. The link between lung ultrasound signs, lung physiopathology and mechanisms of chest physiotherapy techniques allow us to imagine lung ultrasound as a powerful tool for diagnosis and monitoring in respiratory therapy.

1. Lung
Ultrasound
An
Essen1al
Tool
in
Chest
Physiotherapy
Aymeric
Le
Neindre,
PT,
MSc
Department
of
Intensive
Care
Unit,
Groupe
Hospitalier
Paris
Saint-­‐
Joseph,
Paris,
France
Bélaïd
Bouhemad,
MD,
PhD
Department
of
Anesthesiology
and
Surgical
Intensive
Care
Unit,
C.H.U.
de
Dijon
and
Faculty
of
Medicine,
University
of
Burgundy,
France

2. Basics
of
Lung
Ultrasound
A.
Well-­‐Aerated
Lung
The
seashore
sign
(leG,
M-­‐mode)
The
bat
sign
(right,
B-­‐mode)
The
A-­‐lines
(right,
B-­‐mode)
B.
Alveolar-­‐Inters11al
Syndrome
The
B-­‐lines
Mul'ple,
Well-­‐defined
or
Confluent
Lung
Consolida1on
D.
The
shred
sign
(B-­‐mode)
E.
The
1ssue-­‐like
sign
(B-­‐mode)

3. Contribu1on
to
Chest
Physiotherapy
Lung
Aera1on
disorders
assessment
with
High
Accuracy
Guide
the
choice
of
CPT
CPT
and
Pa1ent
monitoring
in
real
1me
Assessment
of
CPT
effec1veness