title: Musculoskeletal techniques for clinically stable adults with cystic fibrosis: a preliminary randomised controlled trial.
abstract: OBJECTIVE
  To assess the sensitivity of selected outcome measures to any change resulting from treatment of adults with cystic fibrosis with physiotherapy musculoskeletal techniques, use the data for sample size calculations for future studies and assess the acceptability of the methods to potential participants.
  
  
  METHODS
  Preliminary, prospective, single-blind, randomised controlled trial.
  
  
  METHODS
  Specialist cystic fibrosis centre.
  
  
  METHODS
  Adults recruited from a cystic fibrosis outpatient clinic.
  
  
  METHODS
  The control group received normal optimal physiotherapy care and the intervention group received weekly musculoskeletal treatment for 6 weeks in addition to normal optimal physiotherapy care.
  
  
  METHODS
  Recorded at baseline, 3, 6 and 12 weeks. The outcome measures were posture (thoracic index), chest wall excursion, forced expiratory volume in 1 second (FEV₁), visual analogue scale for pain, modified shuttle test and Cystic Fibrosis Quality of Life Questionnaire--Section One (physical functioning).
  
  
  METHODS
  Descriptive statistics [using medians and interquartile ranges (IQRs)] and linear regression mixed model.
  
  
  RESULTS
  From a total of 20 subjects, 10 were randomised to each group. Fifty percent of subjects were male, with a median age of 27 years (IQR 25 to 34), median FEV(1) of 1.75 l (IQR 1.4 to 2.4) and median body mass index of 20.8 (IQR 20.0 to 23.5). Baseline differences between groups in thoracic index and modified shuttle test made any differences difficult to interpret, but the results for thoracic index and chest wall excursion at the third rib in the treatment group showed a trend towards improvement. The usefulness of FEV₁, the visual analogue scale for pain and the Cystic Fibrosis Quality of Life Questionnaire as measures is unclear.
  
  
  CONCLUSIONS
  Further musculoskeletal studies in people with cystic fibrosis should consider using thoracic index and a measure of lung function in addition to FEV₁. The musculoskeletal techniques appear to be acceptable to people with cystic fibrosis, and do not seem to have associated adverse effects.
authors.affiliation: Department of Cystic Fibrosis, Royal Brompton & Harefield NHS Foundation Trust, Sydney Street, London SW36NP, UK. catherine.sandsund@rmh.nhs.uk
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Sandsund
authors.forename: Michael
authors.initials: M
authors.lastname: Roughton
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Hodson
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Pryor
mesh_terms: D000328:Adult; D003550:Cystic Fibrosis / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D026201:Musculoskeletal Manipulations / Q000379:methods; D010045:Outpatients; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D011187:Posture / Q000502:physiology; D011446:Prospective Studies; D011788:Quality of Life; D035441:Thoracic Wall / Q000502:physiology