title: Short-term effects of physiotherapy on ventilation inhomogeneity in cystic fibrosis patients with a wide range of lung disease severity.
abstract: BACKGROUND
  Lung clearance index (LCI) is increasingly used as a study endpoint for therapeutic interventions in cystic fibrosis (CF) patients. We set out to assess the effect of chest physiotherapy on ventilation inhomogeneity in clinically stable patients with CF lung disease of varying severity.
  
  
  METHODS
  In 29 CF patients (7.3-43.7 years) N2MBW (nitrogen multiple breath washout), plethysmography, and spirometry measurements were conducted, followed by 30 min of supervised PEP mask chest physiotherapy and repeated measurements 30 min after therapy.
  
  
  RESULTS
  We observed a mean change in LCI after physiotherapy from 15.00 to 14.80 (range, -4.84 to 3.37; p=0.578). In seven patients, LCI decreased, and in ten patients, LCI increased by ≥1. For the whole group, statistically significant improvements were seen in Reff, FEV1, FVC, and MEF50.
  
  
  CONCLUSIONS
  By opening up previously poorly ventilated lung regions, physiotherapy may either increase or decrease ventilation inhomogeneity; the short-term effect of physiotherapy on LCI appears to be unpredictable.
authors.affiliation: Respiratory and Allergic Disease Division, Department of Paediatrics and Adolescent Medicine, Medical University of Graz Austria.
authors.forename: A
authors.initials: A
authors.lastname: Pfleger
authors.affiliation: Respiratory and Allergic Disease Division, Department of Paediatrics and Adolescent Medicine, Medical University of Graz Austria.
authors.forename: M
authors.initials: M
authors.lastname: Steinbacher
authors.affiliation: Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz Austria.
authors.forename: G
authors.initials: G
authors.lastname: Schwantzer
authors.affiliation: Respiratory and Allergic Disease Division, Department of Paediatrics and Adolescent Medicine, Medical University of Graz Austria.
authors.forename: E
authors.initials: E
authors.lastname: Weinhandl
authors.affiliation: Respiratory and Allergic Disease Division, Department of Paediatrics and Adolescent Medicine, Medical University of Graz Austria.
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Respiratory and Allergic Disease Division, Department of Paediatrics and Adolescent Medicine, Medical University of Graz Austria. Electronic address: ernst.eber@medunigraz.at.
authors.forename: E
authors.initials: E
authors.lastname: Eber
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D026741:Physical Therapy Modalities; D010991:Plethysmography; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013147:Spirometry; D055815:Young Adult
keywords: Airway clearance; Cystic fibrosis; Lung function test; Multiple breath washout; Physiotherapy; Spirometry