Physiotherapy and cystic fibrosis

McIlwaine, Maggie; Son, Nicole Marie Lee; Richmond, M.

doi:10.1097/mcp.0000000000000110

Cited by 35 publications

(36 citation statements)

References 21 publications

(15 reference statements)

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“…Alda Marques 1,2* , Joana Cruz 1,2 , Cristina Jácome 1,2 and Ana Oliveira 1,2 *Address all correspondence to: amarques@ua.pt…”

Section: Author Detailsmentioning

confidence: 99%

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Outcome Measures for Respiratory Physiotherapy in Cystic Fibrosis — Challenges and Advances

Marques¹,

Cruz²,

Jácome³

et al. 2015

Cystic Fibrosis in the Light of New Research

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Respiratory physiotherapy is part of the routine management of patients with cystic fibrosis. It normally consists of airway clearance techniques and exercise training. The evidence of such interventions has been questioned. Nevertheless, the lack of evidence should not be interpreted as lack of benefit. Instead, attention to methodological issues, such as the selection of the outcome measures, is needed, as they may hamper the establishment of the effectiveness of respiratory physiotherapy techniques. Hence, this chapter presents and discusses the strengths and weaknesses of conventional and emerging outcome measures possibly to be used i in clinical practice before, during and after each session of respiratory physiotherapy to monitor its effectiveness ii before and after the respiratory physiotherapy treatment i.e., normally characterised by weeks of intervention and iii in applied research in respiratory physiotherapy used in the management for cystic fibrosis. " comprehensive overview of the available outcome measures is provided, with particular emphasis on their strengths and limitations that should be recognised when interpreting the results.

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“…Alda Marques 1,2* , Joana Cruz 1,2 , Cristina Jácome 1,2 and Ana Oliveira 1,2 *Address all correspondence to: amarques@ua.pt…”

Section: Author Detailsmentioning

confidence: 99%

“…Respiratory physiotherapy is a non-pharmacological treatment commonly provided to patients with cystic fibrosis (CF) [1]. According to international guidelines, respiratory physiotherapy is a key element of care for patients with CF, as it aims at both rehabilitation and prevention [2].…”

Section: Introductionmentioning

confidence: 99%

Outcome Measures for Respiratory Physiotherapy in Cystic Fibrosis — Challenges and Advances

Marques¹,

Cruz²,

Jácome³

et al. 2015

Cystic Fibrosis in the Light of New Research

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show abstract

“…Physiotherapy is an integral part of the treatment of CF [ 2 ] and the clinical efficacy of airway clearance is well established [ 3 ][ 4 ][ 5 ][ 6 ]. According to a recent Cochrane systematic review, no single airway clearance technique has shown superiority [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The immediate effects of a single autogenic drainage session on ventilatory mechanics in adult subjects with cystic fibrosis

et al. 2018

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IntroductionThe aim of this study was to gain insight into the physiological changes occurring in subjects with cystic fibrosis (CF) after autogenic drainage (AD). Changes in respiratory system resistance (Rrs), reactance (Xrs), and spirometry were analyzed in adult CF subjects after a single AD physiotherapy session.MethodsThis prospective observational study was conducted during the annual check-up of adult CF subjects in stable condition. Spirometry and Rrs and Xrs measurements using the forced oscillations technique at 5, 11, and 19 hertz (Hz) were performed before and 30 min after a 20-min AD session. Control CF subjects were tested at baseline and 50 min without AD. Results are expressed as mean ± standard deviation or median [interquartile range].ResultsThirty subjects were included in the physiotherapy group (age 29 [25–34] years, forced expiratory volume in 1 s (FEV1) 40.3 [30.1–57.9]% predicted) and 11 in the control group (age 31 [28.5–36.5] years, FEV1 43.6 [31.1–51.9] % predicted). No significant changes in any parameter were observed in the control group. AD modestly but significantly increased the forced vital capacity (FVC) and FEV1 (p<0.001). Inspiratory resistance was also significantly improved by AD: Rrs5 from 5.74±2.39 to 5.24±2.17 cmH2O/L/s, p<0.05; Rrs11 from 4.83±1.98 to 4.32±1.7 cmH2O/L/s, p = 0.003; and Rrs19 from 4.18 [3.46–5.07] to 3.86 [2.76–4.98] cmH2O/L/s, p<0.001. In contrast, AD had no significant effects on frequency dependence of resistance (Rrs5–Rrs19) or expiratory resistance. Inspiratory Xrs5, but not ΔXrs5 (expiratory—inspiratory Xrs), was improved by AD (p<0.05). Moderate correlations were detected between the improvement in FEV1 and FVC and inspiratory resistance (r = 0.53, p = 0.005 and r = 0.44, p = 0.02, respectively).ConclusionA single session of AD improved inspiratory airway resistance, except in the distal airways. The forced oscillations technique provides a new tool for understanding the pathophysiological effects of airway clearance physiotherapy in CF.

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“…Several long-term studies have looked at the efficacy of different airway clearance techniques and reported a positive impact on airway clearance in maintaining health with no technique being superior to another. 11 Some authors claim that certain airway clearance techniques could exacerbate GOR and even suggest that postural drainage with a head-down tilt is contra-indicated in patients with GOR. 12,13 Intrapulmonary percussive ventilation (IPV) delivers small bursts of high-flow gas at 100-300 cycles/min, which causes a counterflow and vibrations of the airway walls.…”

Section: Introductionmentioning

confidence: 99%

Influence of intrapulmonary percussive ventilation in upright position on gastro‐oesophageal reflux in infants

Ginderdeuren

Kerckhofs

Deneyer

et al. 2016

Pediatric Pulmonology

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Physiotherapy and cystic fibrosis

Abstract: The role of physiotherapy in CF is complex and includes airway clearance, exercise, and management of the long-term sequelae of musculoskeletal issues. More rigorous physiotherapy studies are required to assist with evidence based practice.

Cited by 35 publications

References 21 publications

Outcome Measures for Respiratory Physiotherapy in Cystic Fibrosis — Challenges and Advances

Outcome Measures for Respiratory Physiotherapy in Cystic Fibrosis — Challenges and Advances

The immediate effects of a single autogenic drainage session on ventilatory mechanics in adult subjects with cystic fibrosis

Influence of intrapulmonary percussive ventilation in upright position on gastro‐oesophageal reflux in infants

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