The literature has indicated that directed coughing is as effective as conventional physiotherapy in the treatment of cystic fibrosis and may increase patient compliance with treatment. Conventional physiotherapy in these studies included postural drainage, percussion, vibrations and breathing exercises, but did not include breathing control or the forced expiration technique. This study compared three treatment regimens in 24 patients with cystic fibrosis. Regimen A consisted of sitting and coughing, regimen B comprised postural drainage in gravity assisted positions with the active cycle of breathing techniques which includes thoracic expansion exercises, breathing control and the forced expiration technique and regimen C the active cycle of breathing techniques in sitting. During treatment using regimen B significantly more sputum was expectorated than with either regimens A or C (p < 0.01). There was as significant difference between the treatment sputum and the non-treatment sputum using regimens B and C (p < 0.001 and p < 0.01 respectively). There was no difference using regimen A. This study indicated that physiotherapy using gravity assisted positions and the active cycle of breathing techniques was the most effective and independent way of clearing excess bronchopulmonary secretions in this group of subjects with cystic fibrosis.

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