The evidence regarding exercise training in the management of cystic fibrosis: a systematic review.
OBJECTIVE
To conduct a systematic review of the evidence regarding the efficacy of exercise training in the management of cystic fibrosis (CF).


METHODS
Articles were found by searching PEDRO, MEDLINE, and CINAHL databases. Included articles involved exercise-related interventions for long-term adaptations (ie, not acute effects of exercise). Articles were excluded if the language was other than English or if other non-exercise interventions were used. Date of publication was not a factor for exclusion. Two independent reviewers evaluated the included articles using Sackett's levels of evidence and select scoring criteria.


RESULTS
Twelve articles were eligible for inclusion. Interventions studied included various aspects of exercise training: anaerobic, aerobic, or resistance training. Study end-points included pulmonary function, aerobic capacity, strength, and health-related quality of life (HRQL).


CONCLUSIONS
Exercise training in individuals with CF is beneficial, with aerobic and resistance training having the greatest support in the literature for improved aerobic capacity and strength, respectively. Exercise training does not appear to have an effect of improving pulmonary function, but may have a preservation effect. Strong conclusions about improvement in HQRL from exercise training cannot be made. However, greater consistency in measuring this outcome is needed in future trials. There is a paucity of evidence regarding the role of exercise training in reducing hospitalization and health care utilization, and questions raised by this review should be considered in the design of future trials.
Shoemaker
Michael J
MJ
Grand Valley State University, Physical Therapy Program, Grand Rapids, Michigan.
Hurt
Heather
H
Arndt
Leah
L
Chest. 2004 Oct;126(4):1204-14
15486384
J Pediatr. 2002 Feb;140(2):156-64
11865265
Am J Phys Med Rehabil. 1997 Jul-Aug;76(4):311-5
9267191
Arch Dis Child. 1982 Aug;57(8):587-9
7114877
J Pediatr. 2007 Aug;151(2):134-9, 139.e1
17643762
J Pediatr. 2004 Jun;144(6):711-8
15192614
Chest. 2004 Apr;125(4):1299-305
15078738
Arch Dis Child. 2004 Oct;89(10):928-33
15383436
Chest. 2007 Jul;132(1):231-7
17625085
Thorax. 2004 Sep;59(9):783-9
15333856
Chest. 1987 Aug;92(2):273-6
3608598
Pediatr Pulmonol. 1999 Jul;28(1):39-46
10406049
Pediatr Pulmonol. 2002 Mar;33(3):194-200
11836799
Chest. 1981 Oct;80(4):392-8
7023863
Chest. 1994 Feb;105(2):463-8
8306748
J Pediatr. 2000 Mar;136(3):304-10
10700685
Pediatr Pulmonol. 2004 Aug;38(2):115-8
15211693
N Engl J Med. 1992 Dec 17;327(25):1785-8
1435933
Am J Respir Crit Care Med. 2006 Jun 15;173(12):1390-413
16760357
Health Qual Life Outcomes. 2005 Mar 24;3:19
15790407
Chest. 2002 Jan;121(1):64-72
11796433
Phys Ther. 2006 Jul;86(7):955-73
16813476
Chest. 1989 Feb;95(2):344-7
2914486
Thorax. 2004 Dec;59(12):1074-80
15563708
Cochrane Database Syst Rev. 2002;(2):CD002768
12076449
Chest. 2005 Oct;128(4):2347-54
16236893
Pediatr Pulmonol. 1989;7(3):145-52
2797928