Recommended shielding against SARS-CoV-2 impacts physical activity levels and adherence to airway clearance therapy in patients with cystic fibrosis

Abstract

Objectives: To assess the impact of the lockdown during the first and the second wave of the COVID-19 pandemic on airway clearance and physical activity levels among patients with CF.

Methods: A telephone-based survey was conducted among CF patients attending our CF Unit during the “first” and the “second wave of the pandemic” (March-May 2020 and November 2020 – January 2021, respectively).

Results: A total of 120 patients participated, mean (StDev) age 13.8 (8.1)years, mean FEV1 101.0 (24.7)%. An increased proportion of patients increased daily physiotherapy frequency over the second wave of the pandemic (7.5 vs. 14.2%). Moreover, 49.2% of the CF patients performed assisted airway clearance by a physiotherapist visiting their home once a week. Most of the patients (71.2%) decreased assisted physiotherapy during the first wave of the pandemic, while most of the patients did not change the frequency of assisted physiotherapy during the second wave of the pandemic (78%). Before the COVID-19 pandemic, 81% of the CF patients reported performing regular exercise. During the quarantine period, 58.4% of the patients needed to change the exercise type. An increase in the proportion of patients who performed more exercise over the second wave of the pandemic (5.83 vs. 27.8%)

Conclusions: Strict lockdown measures affected patients’ physical activity levels and their daily airway clearance practice. Close monitoring of CF patients and giving them incentives has led them to maintain/increase the adherence to exercise and physiotherapy during such difficult circumstances.