Chest Physiotherapy and Cystic Fibrosis: Measurement Parameters
Physical therapy is only one part of CF management. Thus, it should not be viewed in isolation from the effects of nutrition, medication such as antibiotics, and overall care. Many studies seeking to quantify the effect of CPT on CF, measure the results in terms of changes in pulmonary function, arterial blood gas values, oxygen saturation, and the volume of sputum expectorated in treatment. These measurements will reflect the general state of a CF patient. Changes in these measurements particularly in longitudinal studies cannot be attributed wholly to CPT intervention. natural inhalers for asthma
Cystic fibrosis is a chronic disease resulting in significant anatomic and mechanical distortions of the respiratory system. While measurements such as PFTs and arterial blood gas values will specifically indicate the severity of the disease process, these measurements may be unable to discriminate small and transient changes produced by CPT. More specific measurements, such as pulmonary gas mixing or respiratory muscle oxygen uptake, may be required to assess the effects of CPT.
Cystic fibrosis does not manifest identically in every patient, with the extent of pulmonary and gastrointestinal symptoms varying widely between patients. This variability prompted the development of classification systems based on the comparative severity of symptoms, such as the clinical scores of Shwachman and Kulcycki (1958) and prognostic scores of Taussig et al (1973).
While severity scoring systems are readily available, few studies of CPT incorporate them. It is possible that the results of treatment regimens or techniques may vary according to the patient’s condition. For example, bronchial hyperreactivity occurs in approximately 50% of CF patients. These subjects may respond differently to techniques that have the potential to induce bronchospasm (coughing, AD, etc). The inclusion of these reactive subjects with nonreactive CF subjects would substantially alter the results of a study.