gms | German Medical Science

Objective: This study’s specific objectives are focused on individualizing physiotherapy according to age, compliancy, socio-cultural level, clinical state in pacients with cystic fibrosis.

1. Physiotherapy for the infant – efficiency: postural drainage; percutions and thoracic vibrations; secretion aspiration, 1 year.

2. Physiotherapy for the small child – efficiency and compliance to various schemes of therapy: first stage: physical exercising – 4 months; second stage: classic clearance techniques – 4 months; third stage: clearance techniques combined with physical exercises– 4 months.

3. Physiotherapy and the efficieny of the classic clearance techniques (ACTB and AD) on children aged between 6 and 12, 1 year.

Material/Methods: This study was conducted in the Romanian National Cystic Fibrosis Center in 2007–2010, and the study lot was represented by a number of 49 patients, aged between 2 months and 12 years. For the first sublot, the research plan was conceived by analysing the following aspects: the geneal clinical state and nutritional status; cough character; pulmorary physical signs; bacteriological examination of the sputum; radiological examination through the “Norman & Chrispin” score; pulse oxymetry to assess oxygen saturation. For sublot 2, the methodology was similarly structured as in the case of lot 1, at which specific elements of a higher age were added. For Sublot 3 we have followed the signs of the obstruction of the small air ways (FEF25%–75%), evolution of FEV1, FVC. The statistical processing of data was made with the help of a statistics programme (Graph PadPrism), using a non-parametric test: the Wilcoxon matched pairs test.

Results: Sublot 1 – 1. The evaluation of the efficiency of physiotherapy has shown the substantial benefit in the clinical improvement and of the nutritional status, the reduction of the number of exacerbations of the respiratory suffering and the number of hospitalizations.

Sublot 2 – 2. The combined techniques (physical exercises associated with clearance techniques) have proved to be net superior (72% of cases), both from the point of view of efficiency, as well as compliance (to the patient and to the family).

Sublot 3 – 3. The chosen techniques for the patients between 6 and 12 years old have proven to be effective, especially for improving the respiratory symptomatology and the ventilometric parameters. In this regard, the results of the statistic processing indicate the fact that there are significant statistic differences (p< 0, 05), before and after treatment on all the evalued ventilometric indexes.

Conclusion: Physiotherapy must be mandatory included in the management programme of any patient with cystic fibrosis, must be stared immediately after diagnosis and must be conducted daily. A consistent and true physiotherapy is probably the most important factor in the prevention of a cronic pulmonary infection and, added to antibiotherapy, helps improving the prognostics significantly and helps maintaining a prolonged period of life quality as close as possible to the normal level.

Funding aknowledgement: The production of this study was financially supported with the help of the study grant CNCSIS RO, TE/cod 36.