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Chest physiotherapy in infants with cystic fibrosis: to tip or not? A five-year study

journal contribution
posted on 2003-03-01, 00:00 authored by B M Button, R G Heine, A G Catto-Smith, A Olinsky, P D Phelan, M R Ditchfield, Ian Story
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, 2(1/2) 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 2(1/2) 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 2(1/2) years for those receiving SPT (P = 0.03). Forced vital capacity and forced expired volume in 1 sec (FEV(1)) 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.

History

Journal

Pediatric pulmonology

Volume

35

Issue

3

Pagination

208 - 213

Publisher

John Wiley & Sons

Location

Chichester, Eng.

ISSN

8755-6863

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2003, Wiley-Liss

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