Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis

Main, Eleanor; Rand, S.

doi:10.1002/14651858.cd002011.pub3

Cited by 2 publications

(2 citation statements)

References 105 publications

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“…Therefore, ACT is recommended for all pwCF and should be initiated at the time of diagnosis and performed daily [ 19 , 21 – 23 ]. Given the absence of conclusive findings from observational studies or clinical trials favoring one technique over another, the choice of the optimal ACT should be tailored to individual patient’s needs and preferences [ 19 , 24 ]. Considering the severity of the disease, the use of non-invasive ventilation might be considered [ 25 ].…”

Section: Pulmonary Traitsmentioning

confidence: 99%

Treatable traits and challenges in the clinical management of non-tuberculous mycobacteria lung disease in people with cystic fibrosis

Gramegna,

Misuraca,

Lombardi

et al. 2023

Respir Res

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Introduction Over the last ten years an increasing prevalence and incidence of non-tuberculous mycobacteria (NTM) has been reported among patients with cystic fibrosis (CF) Viviani (J Cyst Fibros, 15(5):619–623, 2016). NTM pulmonary disease has been associated with negative clinical outcomes and often requires pharmacological treatment. Although specific guidelines help clinicians in the process of diagnosis and clinical management, the focus on the multidimensional assessment of concomitant problems is still scarce. Main body This review aims to identify the treatable traits of NTM pulmonary disease in people with CF and discuss the importance of a multidisciplinary approach in order to detect and manage all the clinical and behavioral aspects of the disease. The multidisciplinary complexity of NTM pulmonary disease in CF requires careful management of respiratory and extra-respiratory, including control of comorbidities, drug interactions and behavioral factors as adherence to therapies. Conclusions The treatable trait strategy can help to optimize clinical management through systematic assessment of all the aspects of the disease, providing a holistic treatment for such a multi-systemic and complex condition.

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Section: Pulmonary Traitsmentioning

confidence: 99%

Treatable traits and challenges in the clinical management of non-tuberculous mycobacteria lung disease in people with cystic fibrosis

Gramegna,

Misuraca,

Lombardi

et al. 2023

Respir Res

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show abstract

“…To improve mucus clearance, children and young people with CF (CYPwCF) are taught airway clearance techniques (ACTs) from an early age, which are believed to help reduce infection and improve lung function [ 2 ]. However, clear evidence for the clinical benefits of ACT treatments has been difficult to demonstrate [ 3 – 9 ]. Inability to conceal allocation of treatments from participants during randomisation and personal preference for different types of ACTs have been important confounders limiting clinical trials [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Real-world effectiveness of airway clearance techniques in children with cystic fibrosis

Filipow,

Stanojevic,

Raywood

et al. 2023

Eur Respir J

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BackgroundCystic Fibrosis (CF) is commonly characterised by thick respiratory mucous. From diagnosis, people with CF are prescribed daily physiotherapy, including airway clearance treatments (ACTs). ACTs consume a large proportion of treatment time, yet the efficacy and effectiveness of ACTs are poorly understood. This study aimed to evaluate associations between quality and quantity of ACTs and lung function in children and young people with CF.MethodsProject Fizzyo, a longitudinal observational cohort study, used remote-monitoring electronic pressure sensors with 4 different commercial ACT devices to record real-time, breath-by-breath pressure data during usual ACTs undertaken at home over 16 months in 145 children. ACTs were categorised either as conformant or not with current ACT recommendations based on breath pressure and length measurements, or as missed treatments if not recorded. Daily, weekly and monthly associations between ACT category and lung function were investigated using linear mixed effects regression models adjusting for clinical confounders.ResultsAfter exclusions, 45 224 ACTs (135 individuals) and 21 069 days without treatments (141 individuals) were analysed. Average age of participants was 10.2 years (sd=2.9). Conformant ACTs (21%) had significantly higher FEV1(mean effect size 0.23, 95%CI [0.19, 0.27]) than non-conformant (79%) or missed treatments. There was no benefit from non-conformant or missed treatments, and no significant difference in FEV1between them (mean effect size 0.02 (95%CI, [-0.01, 0.05]).ConclusionACTs are beneficial when done as recommended, but most people use techniques that do not improve lung function. Work is needed to monitor and improve ACT quality and to increase the proportion of people doing effective airway clearance at home.

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Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis

Abstract: Main E, Rand S. Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis.

Cited by 2 publications

References 105 publications

Treatable traits and challenges in the clinical management of non-tuberculous mycobacteria lung disease in people with cystic fibrosis

Treatable traits and challenges in the clinical management of non-tuberculous mycobacteria lung disease in people with cystic fibrosis

Real-world effectiveness of airway clearance techniques in children with cystic fibrosis

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