Chest Physiotherapy and Cystic Fibrosis: Conventional Chest Physical Therapy
Traditionally chest physiotherapy (CPT) aims to improve ventilation and mucociliary clearance through the removal of tenacious and obstructing secretions in patients with cystic fibrosis (CF). The removal of these secretions is thought to relieve atelectasis and prevent or slow the proteolytic destruction of airways by removing the substances likely to promote infection. Controversy exists regarding the efficacy of CPT in achieving these aims; yet, CPT has resulted in acute improvements in pulmonary function and in slowing pulmonary deterioration over time.” The majority of patients with CF are currently required to undertake some daily form of bronchial hygiene during both acute respiratory infections and prophylactically between infections. more
The literature concerning CPT and its effect on the pulmonary function of CF patients is extensive and inconsistent in its findings. The aim of this paper is to review current physiotherapy techniques and present those factors that are confounding the interpretation of the literature. Primarily, studies concentrating on physiotherapy for CF patients will be reviewed, but where relevant, additional studies, whose results are often extrapolated to the management of CF, will be included.
Chest physiotherapy has been incorporated in the management of suppurative lung conditions since the early 1900s. Chest physiotherapy included postural drainage, breathing exercises for relaxation and improving ventilation to atelectatic areas, percussion and vibration for increasing mucociliary clearance, and coughing. This combination of techniques was accepted as the standard daily physiotherapy management for CF patients regardless of the severity of pulmonary disease. Now, it is known as conventional or multimodality physiotherapy.