Chest Physiotherapy and Cystic Fibrosis: Pulmonary Function
The ability of exercise to maintain or improve pulmonary function over a prolonged period has been shown by Orenstein et al (1981), Edlund et al (1986) Andreasson et al (1987), Stanghelle et al (1988), and Salh et al (1989).” These studies investigated the effects of exercise combined with ongoing home physiotherapy programs. Andreasson and associates however, withdrew physiotherapy after 12 months and seven subjects continued with exercise only for an additional 18 months. There was no significant difference between exercise and physiotherapy and exercise alone with respect to vital capacity or FEVi. Changes in total lung capacity and residual volume present a mixed result. Total lung capacity decreased in the initial 12 months of CPT combined with exercise and remained unaltered by the additional 18 months of exercise only, presumably indicating a reduction in air trapping. Residual volume also decreased in the initial 12 months but increased in the following 18 months of exercise only. Holzer et al (1984) noted that supervised physical exercise programs resulted in improvements in measurement variables while unsupervised exercise resulted in low levels of compliance with effects which did not differ from those of the control groups. buy claritin online
Currently, there is considerable disagreement over whether physical exercise should be used as an adjunct to, or instead of, CPT. Exercise programs as a replacement for daily CPT are advocated by the studies of Andreasson et al, Edlund et al, Ober-walder and Zach (1986), Zach et al (1982), Zach et al (1981), and Jankowski (1987). The authors debate that in some cases exercise has been shown to be as effective as conventional CPT, that exercise can improve not only pulmonary function but cardiovascular fitness and work tolerance, and that exercise is more acceptable socially.
Exercise as an adjunct to daily physiotherapy is supported by Olseni et al, Holzer et al, Tuchetta et al (1991), Blomquist et al (1986), Bilton et al (1992), and Salh et al.