Exercise improves mucus clearance in people without lung disease and those with chronic bronchitis. No study has investigated exercise alone for mucus clearance in cystic fibrosis (CF). The aim was to compare treadmill exercise to resting breathing and airway clearance with positive expiratory pressure (PEP) therapy, on mucus clearance in adults with CF. Fourteen adults with mild to severe CF lung disease (FEV1 31 to 113% predicted) completed a three-day randomised, controlled, cross-over trial. Interventions were 20 min of: resting breathing (control); treadmill exercise at 60% of the participant's peak oxygen consumption; and PEP therapy (including huffing and coughing). Mucus clearance was measured using the radioaerosol technique and gamma camera imaging. Treadmill exercise improved whole lung mucus clearance compared to resting breathing (mean difference 3%, 95% CI 2 to 4), however exercise alone was less effective than PEP therapy (mean difference -7%, 95% CI -6 to -8). When comparing treadmill exercise to PEP therapy, there were no significant differences in mucus clearance from the intermediate and peripheral lung regions, but significantly less clearance from the central lung region (likely reflecting the huffing and coughing that was only in PEP therapy). It is recommended to include huffing and coughing to maximise mucus clearance with exercise.
Permission granted by European Respiratory Society Journals Ltd.

Full text (sometimes free) may be available at these link(s):      help

• DOI
• PubMed
• PDF locator
• publisher