Should the physiotherapy outcomes airway clearance, physical activity and fitness be recorded on the Australian Cystic Fibrosis Data Registry? A consensus approach

Angela Potter,Lahni Smith,Carol Maher,Bhavita Pancholi

doi:10.1186/s12890-021-01669-2

Abstract

BackgroundPhysiotherapy is a cornerstone of cystic fibrosis (CF) management, yet the Australian CF Data Registry (ACFDR) currently does not record physiotherapy-related data. This study aimed to gather opinions from lead Australian CF physiotherapists regarding the importance and feasibility of collecting physiotherapy-related data on the ACFDR.MethodsA three-round online Delphi survey was conducted to gather expert stakeholder opinion and consensus agreement. Lead physiotherapists from all 23 Australian CF centres were invited to participate. Round one explored the potential benefits, barriers and importance of recording three physiotherapy-related domains on the ACFDR: airway clearance, physical activity and fitness. Subsequent rounds were developed based on the findings from the previous round and sought consensus (80% agreement) for the inclusion of physiotherapy-related data on the ACFDR and for the most appropriate methods of collecting such data.ResultsThe response rate was > 80% for all rounds. Participants agreed that collection of airway clearance, physical activity and fitness data on the ACFDR was important and feasible. Findings suggested that airway clearance and physical activity should be collected using self-reported questionnaires, while fitness should be measured using a field-based test.ConclusionsAustralian lead CF physiotherapists believe that collection of airway clearance, physical activity and fitness on the ACFDR is important and feasible. Future work is needed to pilot the data collection procedure to examine its feasibility in real-world clinical settings. This study demonstrates how Delphi methodology can provide a contemporary summary of expert clinicians’ opinion that may underpin nation-wide health service improvement.

Highlights

Physiotherapy is a cornerstone of cystic fibrosis (CF) management, yet the Australian CF Data Registry (ACFDR) currently does not record physiotherapy-related data
Along with medications and disease monitoring, physiotherapy is a cornerstone of cystic fibrosis (CF) management [1]
This study describes the considerable efforts undertaken to date to explore the potential addition of airway clearance therapy, physical activity and fitness to the Australian CF data registry

Summary

Introduction

Physiotherapy is a cornerstone of cystic fibrosis (CF) management, yet the Australian CF Data Registry (ACFDR) currently does not record physiotherapy-related data. Physiotherapy has focussed on airway clearance therapy, achieved through manual techniques such as percussions, postural drainage and autogenic drainage, which assist individuals with CF to expectorate respiratory secretions and promote lung. In recent decades, increasing emphasis has been placed on the role of physical activity and exercise, as an adjunct to, or even substitute for, airway clearance techniques [4]. For individuals living with cystic fibrosis, exercise has been shown to improve mucociliary clearance (secondary to increased ease of sputum expectoration and improved ventilation and respiratory flow) [7] and maximal aerobic exercise capacity [8]. The optimal “dosage” of airway clearance techniques, physical activity and fitness is unclear [8]

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