Face mask physiotherapy in cystic fibrosis.

Tyrrell, J C; Hiller, E; Martin, Jennifer

doi:10.1136/adc.61.6.598

Cited by 44 publications

(26 citation statements)

References 3 publications

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“…Positive expiratory pressure mask physiotherapy achieves the same goal by expiring against an external airflow resistence (individually adapted between 10-15 cmH20) [117]. Physical exercise promotes clearance of the lungs and improves the physical condition of CF patients [69].…”

Section: General Considerationsmentioning

confidence: 99%

Cystic fibrosis, pathophysiological and clinical aspects

et al. 1990

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Cystic fibrosis is a lethal, hereditary, until recently little understood disease, which leads to progressive functional disturbances in various organs, including the lungs, liver and pancreas. Knowledge of the genetic and cellular abnormalities is rapidly progressing, but therapy is still symptomatic and based on insufficiently controlled and short-term studies. At present the therapeutic approach aims to combat respiratory infections by optimal antibiotic therapy, combined with techniques to promote sputum evacuation. Additional measures attempt to optimise both nutritional state and physical condition. Median survival has improved from approximately 1 year to about 25 years during the past 3 decades. This article summarises present information on disease mechanisms and treatment.

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Section: General Considerationsmentioning

confidence: 99%

Cystic fibrosis, pathophysiological and clinical aspects

et al. 1990

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“…Several studies have tried to measure lung function changes as a result of expectoration methods, some with negative results [5,19] and some with significant changes even after a single session [11]. Widely varying methodologies in patients with varying severity of lung disease could well explain the different outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Widely varying methodologies in patients with varying severity of lung disease could well explain the different outcomes. Regarding the PEP mask, several studies failed to show an improvement in forced expiratory flows or lung volumes after several weeks of daily treatment [5,20]. In contrast, others showed a significant improvement in lung volumes and expiratory flows after 15 days of PEP mask physiotherapy by CF patients hospitalized for a pulmonary exacerbation [21].…”

Section: Discussionmentioning

confidence: 99%

“…Sputum expectoration, aided by chest physiotherapy (CPT), postural drainage, percussion and coughing, have been standard therapy for many years [1,2]. Self-administered physiotherapy techniques, including the forced expiration technique (FET), active cycle of breathing technique (ACBT), autogenic drainage and the use of a positive expiratory pressure (PEP) mask provide personal independence for the patient and have largely replaced earlier techniques [3][4][5][6][7][8][9][10][11]. It is uncertain whether any of these newer methods, or combinations of different techniques, are better than others [1,[11][12][13][14].…”

Section: Effects Of Flutter and Pep Mask Physiotherapy On Symptoms Andmentioning

confidence: 99%

“…Also, improvement in lung function after 14 days of physiotherapy with the use of the flutter was reported in adult patients with chronic obstructive bronchitis [16] and preliminary data suggest the same for patients with CF [17,18]. In contrast, most studies with the PEP mask failed to show short-term benefit or improvement in lung function or symptoms [5,19,20] or were inconclusive because other aspects of the treatment may have been responsible for an observed effect [21]. It seems, therefore, that the flutter might have advantages over the more commonly used PEP mask.…”

Section: Effects Of Flutter and Pep Mask Physiotherapy On Symptoms Andmentioning

confidence: 99%

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Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis

Winden¹,

Visser²,

Hop³

et al. 1998

Eur Respir J

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Recently, the flutter was introduced as a new device to improve sputum expectoration. Preliminary data suggested a significant improvement in expectoration and lung function during flutter treatment in patients with cystic fibrosis (CF). The aim of the present study was to compare the effects of the flutter and the positive expiratory pressure (PEP) mask on symptoms and lung function in children with CF. In a crossover randomized study 22 patients with CF (mean age 12 yrs, range 7-17 yrs) performed physiotherapy using either the flutter or the PEP mask twice a day during two treatment periods of 2 weeks, separated by a one week wash-out period, in a random sequence. Lung function parameters (peak expiratory flow, forced vital capacity (FVC), forced expiratory volume in one second, maximal midexpiratory flow, maximal expiratory flow at 25% of FVC, thoracic gas volume, total lung capacity, residual volume/total lung capacity, airway resistance and specific airway conductance) and changes in transcutaneous oxygen haemoglobin saturation were assessed before and after the first supervised session and at the end of each treatment period. Throughout the study peak flow was measured and symptoms were scored daily. No significant changes in any lung function parameter occurred after a single session or after 2 weeks of physiotherapy with either method. There was no difference in acceptability and subjective efficacy. In conclusion, any superiority of the flutter over the positive expiratory pressure mask technique for expectoration could not be confirmed during 2 weeks of daily treatment in children with cystic fibrosis. Both methods are well accepted by children and do not change lung function. Long-term comparison of both methods, including expectoration measurements, seems to be required for further evaluation of the potential success of physiotherapy in cystic fibrosis.

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