Exercise for airway clearance in Cystic fibrosis
Cystic Fibrosis (CF) is a genetically inherited disease that predisposes people to a range of complications, with chronic lung infection often being the most problematic. While many people born with CF used to die in childhood or adolescence, management of CF is has improved a lot, such that most now live to adulthood.
Traditionally, one of the recommended components of management are manual physiotherapy techniques designed to clear the airways of infection.
Some similar techniques that the patient can apply independently have also been developed. However, a recent survey of 692 adults with CF has shown that many of these patients elect to use exercise as a substitute for traditional airway clearance techniques.
Whilst several short term studies provide a potential physiological rationale for using exercise as a form of secretion clearance, to date, there is no medium to long term evidence supporting the clinical efficacy of such practice.
The researchers behind the survey therefore recommend that clinicians should question patients about whether they are using exercise in this way, and advise them of the current state of the evidence.
When a person chooses to use exercise as a substitute for airway clearance techniques when well, clinicians should also take the time to discuss that the patient may need to use a traditional airway clearance technique when unwell to improve airway clearance.
Another interesting finding of the survey was that personal experience of participants was a dominant driver of their decision making. Only 7% of participants reported that advice from a physiotherapist was a basis for their beliefs, as opposed to 85% who cited personal experience.
This finding highlights that clinicians should take the time to explore a patient’s beliefs and personal experience as part of the process for prescribing new or modified exercise and airway clearance regimens.
Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!
> From: Ward, J Physiother 65 (2019) 43-50. All rights reserved to the Australian Physiotherapy Association. Click here for the online summary.