Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis (Cochrane Review)

A substantive amendment to this systematic review was last made on 09 February 2000. Cochrane reviews are regularly checked and updated if necessary.

Background: Chest physiotherapy is widely used in patients with cystic fibrosis in order to clear mucus from the airways.

Objectives: To determine the effectiveness and acceptability of chest physiotherapy compared to no treatment or spontaneous cough alone to improve mucus clearance in cystic fibrosis.

Search strategy: Relevant trials are identified in the Cochrane Cystic Fibrosis and Genetic Disorders Group Specialised Register of Controlled Trials. This register was compiled by conducting computerised searches of MEDLINE from 1966 to present and from EMBASE from 1974 to 1995. The register of randomised controlled trials is updated every three months. Unpublished work has been identified by searching through the abstract books of the three major cystic fibrosis conferences; the International Cystic Fibrosis Conference: the European Cystic Fibrosis Conference and the North American Cystic Fibrosis Conference.Date of the most recent search of the Group's specialised register: October 2001.

Selection criteria: Randomised or quasi-randomised clinical trials in which a form of chest physiotherapy (airway clearance technique) were taken for consideration in patients with cystic fibrosis compared with either no physiotherapy treatment or spontaneous cough alone.

Data collection and analysis: Both reviewers independently assessed trial eligibility, extracted data and assessed trial quality.

Main results: One hundred and twenty trials were identified by the search, of which six cross over trials with 66 participants were found eligible for inclusion in the review. Five studies were single treatment studies, in one study each treatment regimen was used twice a day for two consecutive days. Three studies, involving 36 patients, reported the amount of expectorated secretions as an outcome variable, and found a higher amount of expectorated secretions during chest physiotherapy as compared to a control period. Two studies, involving 24 patients found no effect on pulmonary function variables following intervention. In four studies radioactive tracer clearance was used as an outcome variable. In three of these, involving 28 patients, it was found that chest physiotherapy, including coughing, increased radioactive tracer clearance as compared to a control period. One study of eight patients, reported no difference between chest physiotherapy, without coughing, compared to a control period.

Reviewers' conclusions: The results of this review show that airway clearance techniques have short-term effects in the terms of increasing mucus transport. No evidence was found concerning the long-term effects.

Citation: van der Schans C, Prasad A, Main E. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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File Reference: AB001401.htm