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Airway clearance physiotherapy improves ventilatory dynamics during exercise in patients with cystic fibrosis: a pilot study [with consumer summary]
Vendrusculo FM, Johnstone Z, Dhouieb E, Donadio MVF, Cunningham S, Urquhart DS
Archives of Disease in Childhood 2019 Jan;104(1):37-42
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Airflow limitation and dynamic hyperinflation may limit exercise capacity in patients with cystic fibrosis (CF). The aim was to investigate whether the undertaking of airway clearance physiotherapy (ACT) prior to cardiopulmonary exercise testing (CPET) results in improvements in exercise capacity. METHODS: A prospective randomised, cross-over pilot study was performed in children aged > 9 years. Spirometry, plethysmography and CPET were performed on two separate occasions -- one test with ACT prior to CPET and the other without. RESULTS: 12 patients with CF were included in the study with a mean (SD) age of 12.83 (1.85) years. No significant difference in peak oxygen uptake (VO2) was found between the tests. However, lower minute ventilation (VE) and ventilatory equivalents (VEVO2 and VEVCO2) at ventilatory threshold (VT) were noted when ACT was undertaken prior to CPET. The mean (SD) VE (L/min) at VT was 26.67 (5.49) versus 28.92 (6.3) (p = 0.05), VEVO2 (L/min) at VT was 24.5 (1.75) versus 26.05 (2.5) (p = 0.03) and VEVCO2 (L/min) at VT was 26.58 (2.41) versus 27.98 (2.11) (p = 0.03). CONCLUSIONS: These pilot data suggest that ACT prior to exercise may lead to improved ventilatory dynamics during exercise in individuals with CF.
Reproduced with permission from the BMJ Publishing Group.

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