0533 313 82 60 sen_avcil@hotmail.com Leave a message to request an appointment
Member & Past Fellow — American Association for Respiratory Care

Breathing is a skill that can be learned and trained.

I have worked in respiratory physiotherapy since 1996. My aim is not to hand you a single exercise, but to understand together where your breathing gets stuck and to build a measurable programme that gives you room in daily life.

1996Working in respiratory physiotherapy since
3Fellowship programmes completed in the USA
14International publications and conference papers
Dr. Seniha Avcıl, respiratory physiotherapist, in her clinic
Dr. Seniha Avcıl Respiratory Physiotherapist, PhD
AARC International FellowshipNew Orleans, 2012 — Respiratory Care
Mayo Clinic & Cincinnati Children'sFellowship programmes completed in the USA
Hacettepe UniversityPhysical Therapy and Rehabilitation, 1996
PhD — Business AdministrationAcademic work on healthcare service quality
Dr. Seniha Avcıl
About

For nearly thirty years I have asked the same question: where does this person's breathing get stuck?

I graduated from Hacettepe University's Faculty of Physical Therapy and Rehabilitation in 1996 and began my career directly in respiratory physiotherapy. Over twenty-six years at Florence Nightingale Hospital, VKV American Hospital and Memorial Şişli Hospital I worked with a wide range of patients, from intensive care to outpatient follow-up.

During that time I completed international fellowship programmes with the American Association for Respiratory Care, seeing different models of respiratory care first-hand at Cincinnati Children's Hospital, Mayo Clinic and St. David's North Austin Medical Center. Since 2010 I have worked as an instructor and programme coordinator on the same association's training programmes in Türkiye.

Breathlessness is often treated as something to be endured. In most cases, however, there is an area that can be worked on, measured and improved.
  • MSc in Hospital and Health Institutions Management and a PhD in Business Administration, Beykent University
  • Member of the AARC, TÜSAD, the Turkish Thoracic Society and the Turkish Physiotherapy Association
  • Invited speaker at the National Neurology Congress and the Neurorehabilitation Symposium
The Process

What happens at the first appointment?

The decisive stage in respiratory physiotherapy is not the exercise but the assessment that precedes it. The same complaint can have very different mechanisms behind it, and the programme changes accordingly.

The four steps below outline the general flow of a first appointment. Which tests and techniques are used is determined by your individual situation.

01

A detailed history

When your symptoms began, what makes them better or worse, your diagnoses, your medication and where breathing limits you in daily life are all discussed in detail. Any lung function tests, imaging and medical reports are reviewed together.

02

Assessment of breathing pattern

We observe where the breath is taken from, whether the diaphragm is engaged, the rate and rhythm of breathing, whether accessory muscles are recruited, chest wall movement and posture. Cough effectiveness and secretions are also assessed.

03

Measurement and functional testing

Where appropriate, respiratory muscle strength measurement, breath-hold time, sit-to-stand and walking-based functional tests, and breathlessness and fatigue scales are used — so progress is tracked with numbers rather than impressions.

04

An individual programme and follow-up

Techniques, intensity and frequency are set from the assessment, and the home programme is given in writing. Measurements are repeated at intervals and the programme updated accordingly. Written feedback is sent to your doctor where needed.

Approach

I do not claim to improve what I have not measured

Progress in respiratory physiotherapy should not stop at “I feel better”. Where appropriate I use respiratory muscle strength measurement, breathlessness and fatigue scales, and sit-to-stand and walking-based functional tests.

That way we can see whether the programme is working and keep the intensity at the right point. Doing too much is as much of a problem as doing too little.

  • A written home programme: what to do, how many repetitions and how often — in writing.
  • Repeat measurements at intervals: the programme is not fixed; it is updated on the data.
  • Alignment with your doctor: written feedback is sent where needed.
  • No overstatement: no promises about outcome or duration; expectations are kept realistic.
Dr. Seniha Avcıl explaining the use of a breathing training device to a patient
Frequently Asked Questions

Common questions

People living with chronic lung conditions such as COPD, asthma or bronchiectasis; those scheduled for or recovering from cardiac, thoracic or upper abdominal surgery; people whose respiratory muscle strength is affected by a neurological condition; children with recurrent chest infections; and adults with persistent breathlessness after an infection. A breathing pattern assessment can also be meaningful for people with no diagnosis who tire quickly. Suitability is determined individually.

No. Diagnosis is the doctor's responsibility. A physiotherapist assesses breathing pattern, muscle strength, cough effectiveness and functional capacity, plans a programme accordingly and refers back to the doctor when needed. The content on this website is general information, not a diagnosis or treatment recommendation.

Informative content can be useful for general awareness. However, which technique is used, at what intensity and how often depends on your diagnosis, breathing pattern and current capacity. A technique chosen wrongly or applied too intensively may not help. The programme is therefore best planned after a face-to-face assessment.

It would not be right to give one answer for everyone. The timeframe depends on the underlying picture, respiratory muscle strength, other conditions and — most of all — how regularly the programme is kept up at home. No promise is made about duration or outcome; progress is tracked with measurements repeated at intervals.

No. Respiratory physiotherapy runs alongside the treatment your doctor has planned, not instead of it. You should not stop your medication or change the dose because you have started physiotherapy; medication is adjusted only by your doctor.

Contact

Let us assess your breathing together

Whether your breathing pattern suits you can only be understood through a face-to-face assessment. Get in touch to request an appointment.