The short term influence of chest physiotherapy on lung function parameters in pediatric bronchiectasis

Abstract

Introduction: Chest physiotherapy is one of the basic treatment modalities for patients with bronchiectasis. The progression of lung disease in patients with bronchiectasis can be evaluated by spirometry and multiple breath washout (MBW) and it is advised to monitor these on a regular basis. However, the short term effect of chest physiotherapy on spirometry and MBW parameters is insufficiently clear and this variability may impact standardization. For CF, available literature denies a short time effect on spirometry and MBW, however for PCD no data are available.

Methods: We performed a prospective cross-over study to evaluate the short term effect of a harmonized chest physiotherapy session using positive expiratory pressure mask on FEV1 and LCI, compared to no intervention in pediatric patients with cystic fibrosis (CF) and primary ciliary dyskinesia (PCD).

Results: A total of 13 pediatric patients was included: 8 with PCD, and 5 with CF. For the whole group, the median change of FEV1 pp was 0,0% (range -8; +8%) in the treatment group, versus 0,0% (range -6; +5%) in the control group (p 0,804 for comparison between intervention and control). For LCI, the median change after physiotherapy was +0,03 (range -3,73; +1,17) versus -0,16 (range -1,42; 1,37) in the control group (p 0,555). Results were similar for the subgroups of PCD and CF separately.

Discussion: In this small group of evaluated patients, we can’t show evidence of a significant short-term influence of chest physiotherapy on FEV1 nor LCI in PCD and CF, although the variability is large. The study group will be extended in the next few months (aim 15 patients in each group), with additional statistical evaluations.