The effects of a postural exercise program added to conventional pulmonary rehabilitation in patients with cystic fibrosis

Abstract

The objective of this study is to investigate the effect of postural exercises addition to pulmonary rehabilitation in children with cystic fibrosis (CF) on pain, exercise tolerance, respiratory function, quality of life, balance and spinal deformities. Patients diagnosed with CF between the ages of 6 and 14 were included in the study. They were randomised into two groups. The first group received pulmonary rehabilitation and posture exercises once a week for six weeks while the second group received only pulmonary rehabilitation. Both groups were followed by phone calls weekly for six months. Patients were evaluated for respiratory function with FEV1, pain level with VAS, exercise tolerance with Modified Shuttle Test (MST), postural stability with Limits of Stability Test (SLT), and Cystic Fibrosis Questionnaire - Revised Application (CFQR). Cobb and Modified Cobb angles were measured for spinal deformities. The assessments were made before the treatment, at the sixth week, the third month and the sixth month after the treatment. Nineteen patients (36.8% female, 63.3% male) with the mean age 9.37 ± 2.17 and mean body mass index (VKI) 16.16 ± 2.36 included into the study. 10 of them were involved to pulmonary rehabilitation and exercise group. Age, VKI, gender and baseline assessment parameters were similar in both groups ( P > 0.05). FEV1 and MST were increased in both groups after treatment; while emotional state ( P = 0.012) and treatment burden ( P = 0.041) subgroups of CFQR were increased only in the group with postural exercises. VAS, SLT, Cobb and modified Cobb inter-group and intra-group values were not shown any difference by treatment ( P > 0.05). It has been observed that adding postural exercises to pulmonary rehabilitation in pediatric CF patients whose postural changes have not yet taken place does not cause significant changes in pain, exercise tolerance, posture and balance; however, it affected the emotional state well and improved the compliance with the treatment.