title: Exercise with incorporated expiratory manoeuvres was as effective as breathing techniques for airway clearance in children with cystic fibrosis: a randomised crossover trial.
abstract: OBJECTIVE
  : Can a session of exercise with incorporated expiratory manoeuvres substitute for a session of breathing techniques for airway clearance in children with cystic fibrosis? Are children with cystic fibrosis as co-operative and satisfied with the exercise regimen as with the breathing techniques?.
  
  
  METHODS
  Randomised, cross-over trial with concealed allocation and intention-to-treat analysis.
  
  
  METHODS
  34 children with cystic fibrosis in a stable clinical state.
  
  
  METHODS
  Participants underwent two 20-min airway clearance interventions on two scheduled clinic days: one involving three bouts of various whole-body exercise modalities each followed by independent expiratory manoeuvres, and the other involving breathing control, thoracic expansions with manual expiratory compressions, and the forced expiratory technique.
  
  
  METHODS
  Wet weight of expectorated sputum, change in lung function, co-operation with treatment, perceived treatment quality, and satisfaction with treatment were all assessed after each intervention.
  
  
  RESULTS
  The wet weight of sputum after exercise was 0.6g higher after the exercise intervention, which was not statistically or clinically significant (95% CI -0.2 to 1.4). However, lung function and participant satisfaction with the treatment were both significantly better after the exercise intervention. Co-operation with treatment and perceived treatment quality were equally high for each intervention.
  
  
  CONCLUSIONS
  A session of various whole-body exercises interspersed with independent expiratory manoeuvres could be an acceptable substitute for a session of breathing control, thoracic expansions with manual expiratory compressions, and the forced expiratory technique in children with mild cystic fibrosis lung disease.
authors.affiliation: Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France. philippe.reix@chu-lyon.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Reix
authors.forename: Françoise
authors.initials: F
authors.lastname: Aubert
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Werck-Gallois
authors.forename: Agnès
authors.initials: A
authors.lastname: Toutain
authors.forename: Corinne
authors.initials: C
authors.lastname: Mazzocchi
authors.forename: Nathalie
authors.initials: N
authors.lastname: Moreux
authors.forename: Gabriel
authors.initials: G
authors.lastname: Bellon
authors.forename: Muriel
authors.initials: M
authors.lastname: Rabilloud
authors.forename: Behrouz
authors.initials: B
authors.lastname: Kassai
mesh_terms: D000293:Adolescent; D001945:Breathing Exercises; D002648:Child; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000534:rehabilitation*; D045853:Exhalation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D013183:Sputum; D016896:Treatment Outcome