Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis

Background Chest physiotherapy is widely used in people with cystic fibrosis in order to clear mucus from the airways. Objectives To determine the effectiveness and acceptability of chest physiotherapy compared to no treatment or spontaneous cough alone to improve mucus clearance in cystic fibrosis. Search methods We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of the most recent search of the Group's Cystic Fibrosis Trials Register: 09 February 2009. Selection criteria Randomised or quasi‐randomised clinical trials in which a form of chest physiotherapy (airway clearance technique) were taken for consideration in people with cystic fibrosis compared with either no physiotherapy treatment or spontaneous cough alone. Data collection and analysis Both authors independently assessed trial eligibility, extracted data and assessed trial quality. Main results One hundred and twenty‐six trials were identified by the search, of which six cross‐over trials with 66 participants were found eligible for inclusion in the review. Five studies were single treatment studies; in one study each treatment regimen was used twice daily for two consecutive days. Three studies, involving 36 participants, found a higher amount of expectorated secretions during chest physiotherapy as compared to a control period. Two studies, involving 24 participants found no significant effect on pulmonary function variables following intervention. In four studies radioactive tracer clearance was used as an outcome variable. In three of these, involving 28 participants, it was found that chest physiotherapy, including coughing, increased radioactive tracer clearance as compared to the control period. One study of eight participants, reported no significant difference between chest physiotherapy, without coughing, compared to the control period. Authors' conclusions The results of this review show that airway clearance techniques have short‐term effects in the terms of increasing mucus transport. No evidence was found on which to draw conclusions concerning the long‐term effects.