title: Long-term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis.
abstract: We report the results of a long-term comparative trial of physiotherapy by the positive expiratory pressure (PEP) technique with a PEP mask (Astra Meditec) versus conventional postural drainage and percussion (PD&P). Forty patients, ages 6 to 17 years, with Shwachman scores between 52 and 93, attending the cystic fibrosis clinic were enrolled in the study and randomly assigned to one of two groups. Group A (control) continued to perform physiotherapy by using PD&P for a 1-year period, whereas patients assigned to group B performed physiotherapy with the PEP technique for the same period. Compliance with physiotherapy was closely monitored for both groups throughout the study. Clinical status and pulmonary function (forced vital capacity [FVC], FEV1, and FEF25-75) were measured at 3-month intervals. Group B (PEP) demonstrated improved pulmonary function in all parameters as measured by change in percent predicted value for age, gender, and height. The changes in pulmonary function over the study period were: FVC, +6.57; FEV1, +5.98; and FEF25-75, +3.32. This improvement was significantly different from that of group A (PD&P) whose pulmonary function declined in all parameters (FVC, -2.17; FEV1, -2.28; FEF25-75, -0.24). The differences between treatment groups were statistically significant for the changes in FVC (p = 0.02) and FEV(1) (p = 0.04). Our results indicate that for our patients with cystic fibrosis, pulmonary physiotherapy with the PEP technique was superior to conventional physiotherapy with the PD&P technique.
authors.affiliation: Department of Paediatrics, University of British Columbia, Vancouver, Canada.
authors.forename: P M
authors.initials: PM
authors.lastname: McIlwaine
authors.forename: L T
authors.initials: LT
authors.lastname: Wong
authors.forename: D
authors.initials: D
authors.lastname: Peacock
authors.forename: A G
authors.initials: AG
authors.lastname: Davidson
mesh_terms: D000293:Adolescent; D002648:Child; D003550:Cystic Fibrosis / Q000503:physiopathology / Q000628:therapy*; D004311:Double-Blind Method; D015916:Drainage, Postural; D005260:Female; D006801:Humans; D008297:Male; D010474:Percussion; D011175:Positive-Pressure Respiration; D012129:Respiratory Function Tests