OBJECTIVE: We report the results of a long-term comparative trial of physiotherapy by the positive expiratory pressure (PEP) technique with a PEP mask (Astra Meditec) versus conventional postural drainage and percussion (PD+P). Forty patients, ages 6 to 17 years, with Shwachman scores between 52 and 93, attending the cystic fibrosis clinic were enrolled in the study and randomly assigned to one of two groups. Group A (control) continued to perform physiotherapy by using PD+P for a 1-year period, whereas patients assigned to group B performed physiotherapy with the PEP technique for the same period. Compliance with physiotherapy was closely monitored for both groups throughout the study. Clinical status and pulmonary function (forced vital capacity (FVC), FEV1, and FEF[25-75]) were measured at 3-month intervals. Group B (PEP) demonstrated improved pulmonary function in all parameters as measured by change in percent predicted value for age, gender, and height. The changes in pulmonary function over the study period were: FVC +6.57; FEV1 +5.98; and FEF[25-75] +3.32. This improvement was significantly different from that of group A (PD+P) whose pulmonary function declined in all parameters (FVC -2.17; FEV1 -2.28; FEF[25-75] -0.24). The differences between treatment groups were statistically significant for the changes in FVC (p = 0.02) and FEV1 (p = 0.04). Our results indicate that for our patients with cystic fibrosis, pulmonary physiotherapy with the PEP technique was superior to conventional physiotherapy with the PD+P technique.

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