[Evaluation of the efficiency of selected thoracic physiotherapy methods used in the treatment of patients with cystic fibrosis]

Abstract

In Poland the standard treatment of pulmonary manifestation of cystic fibrosis consists of physiotherapy techniques of postural drainage with clapping. However many studies demonstrated that various alternative airway clearance techniques performed in Europe the last few years have been more effective than postural drainage. The aim of the study was a comparative analysis of the efficiency of selected chest physiotherapy methods used in the treatment of children with cystic fibrosis. We studied 21 patients, aged 5-18 (x 10.57), who were hospitalised in the Paediatric Clinic of National Research Institute of Mother and Child in Warsaw, Poland. We compared five chest physiotherapy techniques: 1 - postural drainage with clapping, 2 - postural drainage with clapping and vibration, 3 - active cycle of breathing technique, 4 - Flutter(R), 5 - Flutter(R) with relaxation. Every investigated drainage method was tested by each patient according to a determined procedure. The following indices were measured: weight of coughed up sputum, oxygen saturation (SaO2) before, during and after drainage, peak expiratory flaw (PEF) before and after drainage. The biggest quantity of sputum determined by its coughed up weight was with active cycle of breathing technique (x 2.126 g). In comparison, in patients using postural drainage with clapping and clapping with vibration average sputum expectoration was 0.895 and 1.012 g. Flutter device is recommended for individual usage. Our findings demonstrate that the Flutter with relaxation effectively facilitates removal of mucus from airways (Flutter - x 1.48 g, Flutter with relaxation - x 2.012 g). We observed PEF decrease (p > 0.05) during postural drainage with clapping and vibration. There were no significant differences in SaO2 between the values before and after drainage in every investigated technique.