Effect of four physiotherapy schedules on pulmonary function in children with cystic fibrosis.

In 17 children (group A) with cystic fibrosis (CF) the effect of 
the following treatment schedules on pulmonary function has been studied in 
random order on 4 consecutive days: (1) clapping and postural drainage 
(CP); (2) CP after inhaling an aerosol of 5 ml 20% 
N-acetylcysteine by a Monaghan ultrasonic device; (3) as in 2 but 
with the addition of 0.5 mg isoprenaline to the aerosol; (4) 
as in 3 but with an IPPB device added to the 
nebulizer. Treatment was started at 9.30 a.m. and lasted for about 
1 h. Pulmonary function was measured prior to and 30 min 
after treatment (9.00 and 11.00 a.m., respectively). In 8 children (group 
B) with CF (severity comparable to the previous group) pulmonary function 
was measured at 9.00 and 11.00 a.m. but without physiotherapy in 
between. The following pulmonary function measurements have been included in the 
evaluation of the results: VC, FVC, FEV1, TLC (body box), TLC 
(helium dilution), TLCBb-TLCHe, RVBb, RVHe, maximal expiratory flows at 60% TLBBb, 
25% FVC, maximal midexpiratory flow, airway conductance. The technique of the 
determinations was carefully controlled and initial values were reproducible in most 
children. In group B, mean values of pulmonary function were equal 
at 9.00 and 11.00 a.m. In group A none of the 
treatment schedules caused a significant improvement of mean pulmonary function values. 
In some of the children, however, pulmonary function improved, but in 
others it deteriorated. The significance of these findings was discussed. 