Non-invasive ventilation was shown to be a good alternative to PEP in chest physiotherapy for patients with cystic fibrosis who are severely ill.

BACKGROUND: Lung function parameters are used as end points in most clinical and therapeutic trials in cystic fibrosis (CF) and to evaluate the effects of airway clearance techniques. The aim of the study was to identify at what time point after a physiotherapy session spirometry (FEV 1 and FVC) should be performed to obtain the highest result compared to baseline and to determine whether there are inter-individual and intra-individual differences in children and adults with CF. METHODS: This was a prospective study. Twenty-four subjects with CF and mean FVC 70 ؎ 30% and FEV 1 61 ؎ 30% of predicted were included. Each subject performed spirometry before their airway clearance session and then immediately after, 30 min after, and 1, 2, and 3 h after their physiotherapy session for 2 consecutive days. RESULTS: In adult subjects, mean FEV 1 improved 30 min (P < .001), 1 h (P < .002), and 2 h (P < .006) after physiotherapy compared to baseline. In pediatric subjects, it improved immediately after the session but was not statistically significant for recommendation. There were no intra-individual variations, but there were inter-individual variations (not statistically significant). CONCLUSIONS: Performing spirometry 30 min (adults) and immediately (children) after a session might be optimal if individual peak time values cannot be used.

'Becoming Friends with NIV' involves a learning process for adults with CF. To facilitate this learning process, different aspects should be taken into account so as to promote independence and self-management, which in turn allows the patient to experience the treatment as meaningful. The findings are relevant to physiotherapists working with adults and NIV, as improved insight into and understanding of the relationship may have a positive influence on the outcome and success of NIV usage.

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