Individualized unsupervised exercise programs and chest physiotherapy in children with cystic fibrosis

Traditionally, physiotherapy for cystic fibrosis focused mainly on airway clearance (clearing mucus from the lungs). This still makes up a large part of daily treatment, but the role of the physiotherapist in cystic fibrosis has expanded to include daily exercise, inhalation therapy, posture awareness and, for some, the management of urinary incontinence. The purpose of this study is to demonstrate the necessity and the efficiency of various methods of chest physiotherapy and individualized unsupervised exercise program, in the improvement of body composition and physical performance. This study included 12 children with cystic fibrosis, with ages between 8-13 years. Each subject was evaluated in terms of body composition, effort capacity and lower body muscular performance, at the beginning of the study and after 12 months. The intervention consisted in classic respiratory clearance and physiotherapy techniques (5 times a week) and an individualized unsupervised exercise program (3 times a week). After 12 months we noticed a significant improvement of the measured parameters: body weight increased from 32.25±5.5 to 33.53±5.4 kg (p <0.001), skeletal muscle mass increased from a mean of 16.04±4.1 to 17.01±4.2 (p<0.001), the fitness score, increased from a mean of 71±3.8 points to73±3.8, (p<0.001) and power and force also registered positive evolutions (from 19.3±2.68 to 21.65±2.4 W/kg and respectively 19.68±2.689 to 20.81±2.98 N/kg). The association between physiotherapy procedures and an individualized (after a proper clinical assessment) unsupervised exercise program, proved to be an effective, relatively simple and accessible (regardless of social class) intervention.