Musculoskeletal aspects of respiratory function in cystic fibrosis: a cross-sectional comparative study

Abstract

Background: Respiration is an intricate interaction between visceral and musculoskeletal structures. In cystic fibrosis (CF), the airways and lungs are subject to progressive obstruction and destruction. However, knowledge about the musculoskeletal aspects of respiratory function and symptoms is still limited in this patient group.

Methods: In a cross-sectional comparative study, 21 adults with CF enrolled at the Gothenburg CF Centre were matched with 42 healthy controls. The two groups were examined and compared in terms of thoracic mobility, respiratory muscle strength, lung function, and musculoskeletal pain in accordance with a predefined protocol.

Results: Significant differences were observed between the groups in the number of tender points, thoracic excursion, forced vital capacity (FVC), and forced expiratory volume (FEV). The CF group also demonstrated a tendency toward reduced function in other measurements, although these were not statistically significant.

Conclusion: This cross-sectional study revealed that people with CF have reduced thoracic mobility and an increased prevalence of muscular tender points, alongside decreased lung function, compared to healthy controls. These findings stress the need for greater emphasis on the often-overlooked musculoskeletal aspects of CF care, especially as people with CF are living longer and may require more musculoskeletal health support.

Keywords: Cystic fibrosis; muscle strength; musculoskeletal pain; respiration; thoracic mobility.

Figure 1.

Number of TPs presented in median, interquartile range (IQR) and outliers by the Cystic fibrosis group compared to the healthy controls per anatomical area: 1) cervical Spine: CF group (3.0; 2.0–5.0) compared to healthy controls (0.5;0.0–1.3) (p <0.001). 2) thoracic Spine: CF group (3.0; 1.0–4.5) compared to healthy controls (0.0;0.0–2.0) (p <0.001). 3) Lumbar Spine: CF group (0.0;0.0–1.0) compared to healthy controls (0.0;0.0–0.0) (p = 0.016). 4) costo-vertebral Joints: CF (3.0;1.5–7.0) compared to healthy controls (0.0;0.0–1.0) (p <0.001). 5) costo-sternal Joints: CF group (1.0;0.0–4.5) compared to healthy controls (0.0;0.0–0.0) (p <0.001). Circles and asterisks represent data points outside the IQR, considered as mild or notably distant outliers respectively.