Chest physiotherapy in infants with cystic fibrosis:

[Guest guest]

Hi,

I am not sure whether this article was already posted here. It's quite

interesting in that is says that the head-down-position has negative

side-effects and that you better do the CPT without it.

Peace

Torsten, dad of Fiona 5wcf

e-mail: torstenkrafft@...

Online ISSN: 1099-0496 Print ISSN: 8755-6863

Pediatric Pulmonology

Volume 35, Issue 3, 2003. Pages: 208-213

Published Online: 31 Jan 2003

Copyright © 2003 Wiley-Liss, Inc

Diagnostic and Therapeutic Methods

Chest physiotherapy in infants with cystic fibrosis:

To tip or not? A five-year study

M. Button, Dip Phty, PhD 1 2 *, Ralf G. Heine,

MD, FRACP 3 5, G. Catto-, MD, FRACP 3 5,

Olinsky, MD, FRACP 4, D. Phelan, MD,

FRACP 5, R. Ditchfield, MD, FRANZCR 6, Ian

Story, PhD 2

1Department of Physiotherapy, Royal Children's

Hospital, Melbourne, Australia

2School of Physiotherapy, University of Melbourne,

Melbourne, Australia

3Department of Gastroenterology and Clinical

Nutrition, Royal Children's Hospital, Melbourne,

Australia

4Department of Respiratory Medicine, Royal Children's

Hospital, Melbourne, Australia

5Department of Paediatrics, University of Melbourne,

Melbourne, Australia

6Department of Radiology, Royal Children's Hospital,

Melbourne, Australia

email: M. Button (b.button@...)

*Correspondence to M. Button, Department of

Respiratory Medicine, Alfred Hospital, Commercial

Road, Prahran, Melbourne, 3181, Australia.

Funded by:

Royal Children's Hospital Research Foundation,

Melbourne

Physiotherapy Research Foundation of Australia

Keywords

cystic fibrosis . gastroesophageal reflux .

physiotherapy . postural drainage . infant .

aspiration . pulmonary function . treatment

Abstract

There is controversy about the need for postural

drainage physiotherapy in asymptomatic infants with

cystic fibrosis (CF). We aimed to compare the

effectiveness of standard postural drainage chest

physiotherapy (SPT) with a modified physiotherapy

regimen without head-down tilt (MPT) in young infants

with CF. Twenty newly diagnosed infants with CF (mean

age, 2.1 months; range, 1-4) were randomized to SPT or

MPT. Parents kept a detailed symptom and treatment

diary for the following 12 months. Serial chest

radiographs, taken at diagnosis, 12 months, 2½ years,

and 5 years after diagnosis, were assessed using the

Brasfield score. Pulmonary function tests were

compared between groups after 5 years. Of the 20

infants, 16 (80%) completed the review at 12 months,

and 14 (70%) at 2½ and 5 years. Patients receiving SPT

had more days with upper respiratory tract symptoms

than those on MPT (70 ± 32.8 vs. 37 ± 24.9 days; P =

0.04) and required longer courses of antibiotics (23 ±

28.5 vs. 14 ± 11.2 days; P = 0.05). Chest x-ray scores

were similar at diagnosis but were worse at 2½ years

for those receiving SPT (P = 0.03). Forced vital

capacity and forced expired volume in 1 sec (FEV1) at

5-6 years was lower for SPT than for MPT (P < 0.05).

In conclusion, MPT was associated with fewer

respiratory complications than SPT in infants with CF.

Pediatr Pulmonol. 2003; 35:208-213. © 2003 Wiley-Liss,

Inc.

Received: 11 December 2001; Accepted: 1 October 2002

Digital Object Identifier (DOI)

10.1002/ppul.10227 About DOI

References are available in the Enhanced Abstract