Abstract
Background: Pulmonary disease is the main cause of morbidity and mortality in cystic fibrosis (CF). Children with CF usually received chest physiotherapy as a part of their management.
Aim of Study: To systematically review the effect of chest physiotherapy on pulmonary functions in children with CF.
Patients and Methods: Articles were identified through literature search using PubMed (MEDLINE), physiotherapy evidence database (PEDro) and Cochrane database from 2000 up to February 2019. Studies were included if they were randomized trials focused on chest physiotherapy in children with CF. Data from included studies was extracted and its methodological quality was assessed using PEDro scale. The modified Sackett scale was used to assess level of evidence of each intervention.
Results: Seven trials were identified with fair to good methodological quality. Studies were heterogeneous in regards to intervention techniques; findings were qualitatively ana-lyzed. This review found moderate evidence about the effec-tiveness of postural drainage (PD), autogenic drainage(AD), non-invasive ventilation and independent active cycle of breathing technique(ACBT); limited evidence for the effec-tiveness of modified PD, Positive Expiratory Pressure (PEP) and therapist-assisted ACBT. Moderate evidence was found that Hayek oscillator or chest physiotherapy during anaesthesia preoperatively is ineffective in improving pulmonary functions in children with CF.
Conclusion: The present evidence supports the use of different chest physiotherapy interventions for improving pulmonary functions in children with CF.