Short-Term Effect of Different Physical Exercises and Physiotherapy Combinations on Sputum Expectoration, Oxygen Saturation, and Lung Function in Young Patients with Cystic Fibrosis.

Abstract

Exercise and chest physiotherapy are integral components of cystic fibrosis (CF) care. We aimed to determine short-term effects of a combined exercise-physiotherapy intervention, using either trampoline or cycle exercises compared to billiard (sham training) on sputum production, oxygen saturation (SaO2) and short-term lung function in participants with CF. Twelve 16- to 29-year-old individuals with CF were randomly allocated to all 3 interventions on non-consecutive days of a week with exercise and physiotherapy parts lasting 30min and breaks of 30min after each procedure. Sputum weight (g) and lung function were measured before and after the exercise+rest and physiotherapy+rest interventions and SaO2 was measured before and after the combined interventions. Differences in outcome measures between the different exercises and combined exercise/physiotherapy regimens were analyzed by univariate multilevel linear regression. Sputum expectoration during and after trampoline exercise was significantly higher than with and after billiard (P=0.021), and tended to be higher than with and after cycling of similar cardiovascular intensity (P=0.074). Sputum weights during and after physiotherapy were comparable among sessions, irrespective of the prior exercise or sham procedure. The increase in SaO2 was significantly higher after the combined trampoline/physiotherapy (1.7±0.9%) and cycling/physiotherapy (1.8±0.8%) sessions compared to billiard/physiotherapy (0.5±1.8%, P=0.011 and P=0.007). No effects were observed on lung function. Exercise followed by physiotherapy has an additive effect on sputum production in participants with CF and leads to improved oxygen saturation. Exercises with increased ventilation combined with mechanical vibration seem to be most efficient.