Beyond postural drainage and percussion: Airway clearance in people with cystic fibrosis.
BACKGROUND
Evidence indicates that there are no statistically significant differences in effectiveness among the airway clearance techniques (ACTs) of active cycle of breathing, autogenic drainage, positive expiratory pressure (PEP) or oscillating PEP in the short-term, but are there differences in the long-term (one year)? The objective of the study was to demonstrate non-inferiority in the long-term.


METHODS
Seventy-five people with cystic fibrosis entered the prospective, randomised controlled trial of these five different ACTs. The primary outcome measure was forced expiratory volume in one second (FEV(1)). Secondary outcome measures included exercise capacity and health related quality of life.


RESULTS
Using intention to treat, data were available on 65 subjects at the end of the study period. There were no statistically significant differences among the regimens in the primary outcome measurement of FEV(1) (p=0.35).


CONCLUSIONS
In different countries either one or several airway clearance regimens are used. This study provides evidence in support of current practices.
Department of Cystic Fibrosis, Royal Brompton & Harefield NHS Foundation Trust, London SW3 6NP, UK.
J A
JA
Pryor
E
E
Tannenbaum
S F
SF
Scott
J
J
Burgess
D
D
Cramer
K
K
Gyi
M E
ME
Hodson
D000293:Adolescent; D000328:Adult; D001945:Breathing Exercises; D035641:Chest Wall Oscillation; D003550:Cystic Fibrosis / Q000503:physiopathology / Q000628:therapy*; D015916:Drainage, Postural; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D055815:Young Adult