Impact of hypertonic saline nebulization combined with oscillatory positive expiratory pressure on sputum expectoration and related symptoms in cystic fibrosis: a randomized crossover trial

To evaluate the impact of combining nebulised hyaluronic acid plus hypertonic saline (HA  + HS) with oscillatory positive expiratory pressure (oscillatory-PEP) on sputum expectoration and related symptoms in adults with cystic fibrosis (CF).
Source: Physiotherapy - Category: Physiotherapy Authors: Source Type: research

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CONCLUSIONS: The evidence provided by this review is of variable quality, but suggests that all techniques and devices described may have a place in the clinical treatment of people with CF. Following meta-analyses of the effects of PEP versus other airway clearance techniques on lung function and patient preference, this Cochrane Review demonstrated that there was high-quality evidence that showed a significant reduction in pulmonary exacerbations when PEP using a mask was compared with HFCWO. It is important to note that airway clearance techniques should be individualised throughout life according to developmental stage...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Introduction and Objectives: COPD is a small airway disease associated with ventilation heterogeneity. The LCI is more sensitive than FEV1 in cystic fibrosis however its place in COPD monitoring is unknown. We evaluated the use of the LCI among subjects with COPD comparatively to spirometry, BMI and exacerbation frequency. LCI can be time intensive and therefore we explored the potential of using a shortened LCI to 1/20th concentration.Methods: The LCI was measured by performing a Multiple Breath Washout using a modified photoacoustic Innocor device with 0.2% Sulphur Hexafluoride on subjects with COPD (N=84). The LCI was r...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
Conclusion: The Aerobika* OPEP device was found to be acceptable for patients and therapists. Improvement in CAT scores were observed in 60% of COPD patients. Inclusion of the Aerobika* should be considered as an acceptable adjunct to ACT physiotherapy regimes for those with CF, bronchietasis or COPD
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
Chest physiotherapy is used to extract mucus excess from the lung. Two main types of techniques have been based on air-mucus interaction: high air flows applied at standard lung volumes; low air flows at small lung volumes. Both are hypothesized to bring shear stress high enough to overcome mucus yield stress. However, no full understanding of the underlying biophysics involved exists as today.Our goal is to reach scientific insights on how the shear stress behaves in the bronchial tree for these two different approaches of chest physiotherapy.We developped a mathematical model to compute the quasi-static shear stress in t...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory function technologists/scient. Source Type: research
Aim: The study aimed to determine lung function, functional capacity, energy cost, and nutritional status in cystic fibrosis (CF) patients with and without inspiratory muscle weakness (IMW). It was also aimed to investigate the relationship between energy cost and lung function, functional capacity, and nutritional status.Methods: Forty-four CF patients (13.70±3.97 yrs, 30M, 24F) participated in this study. Lung function tests and the six-minute walk test (6MWT) were performed. The physiological cost index (PCI) was calculated by the difference between resting heart rate and heart rate at the end of the 6MWT, divide...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
This study was aimed to compare arm functional capacity and activities of daily living between CF and PCD.Methods: Eleven patients with cystic fibrosis (4M, 7F) and 11 patients with PCD (3M, 8F) were included in the study. Subjects’ demographic characteristics and pulmonary function parameters were recorded. Respiratory muscle strength (MIP and MEP) was assessed using portable mouthpiece device. Peripheral muscle stength (QMS) was evaluated using hand held dynamometer. Hand grip strength (HGS) was measured using JAMAR hand dynamometer. Arm functional capacity was assessed using the six-minute pegboard and ring test (...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
Aim: The aim of the study was to compare gait parameters and functional balance in patients with non-cystic fibrosis (CF) bronchiectasis and healthy subjects.Methods: Fifteen patients with non-CF bronchiectasis (49.50±5.80 years, 10 males, 5 females) and 14 healthy individuals (45.36±4.27 years, 10 males, 4 females) participated in this study. The functional balance was assessed using the Timed Up and Go (TUG) test. The gait parameters were assessed using the Biodex Gait Trainer. Step cycle (sec), walking speed (m/sec), the number of steps per minute, and ambulation index were measured for six minutes. Qualit...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
Background: Chronic respiratory diseases contribute to the development of anxiety and depression. In bronchiectasis (BE), it is unclear whether these comorbidities are related to general or disease-related quality of life (HRQoL) or symptoms.Aims: To evaluate the correlation between anxiety and depression and QoL in patients with BE.Methods: 26 subjects with non-cystic fibrosis BE of both sexes, 56±16 years, classified by the Bronchiectasis Severity Index (BSI), answered to the Mini Mental State Examination (MMSE), Anxiety and Depression Scale (HADS), Medical Outcomes Study 36 – Item Short – Form Health ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
Chronic rhinosinusitis (CRS) and nasal polyposis are common comorbidities among Cystic Fibrosis (CF) patients. These conditions are managed with education to routine nasal irrigations, periodical follow-ups that consists of quality of life questionnaires, annual nasal fibroscopy and nasal lavage fluid analysis.Aim: To retrospectively analyze CF patients with symptoms of chronic rhinosinusitis and nasal polyposis.An observational retrospective analysis was performed from 2017 to 2018 among clinically stable adult CF patients. Respiratory function indices, anthropometric data, routine airway clearance techniques and Sino-nas...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
Conclusion: Cognitive and motor development was delayed in more than half of (5/9) the infants with CF. Neurodevelopmental assessment should be done as early as possible and neurodevelopmental level should be followed in infants with CF. If required, these infants should be supported by early developmental physiotherapy and rehabilitation.Keywords: Cystic fibrosis, neurodevelopment, physiotherapy.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
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