Skip to main content
PMC home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 2004;97(Suppl 44):8–25.

Physiotherapy in infants and young children with cystic fibrosis: current practice and future developments.

Louise Lannefors 1, Brenda M Button 1, Maggie McIlwaine 1
PMCID: PMC1308795  PMID: 15239290

Full Text

The Full Text of this article is available as a PDF (2.0 MB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amitani R., Wilson R., Rutman A., Read R., Ward C., Burnett D., Stockley R. A., Cole P. J. Effects of human neutrophil elastase and Pseudomonas aeruginosa proteinases on human respiratory epithelium. Am J Respir Cell Mol Biol. 1991 Jan;4(1):26–32. doi: 10.1165/ajrcmb/4.1.26. [DOI] [PubMed] [Google Scholar]
  2. Andréasson B., Jonson B., Kornfält R., Nordmark E., Sandström S. Long-term effects of physical exercise on working capacity and pulmonary function in cystic fibrosis. Acta Paediatr Scand. 1987 Jan;76(1):70–75. doi: 10.1111/j.1651-2227.1987.tb10417.x. [DOI] [PubMed] [Google Scholar]
  3. Aris R. M., Renner J. B., Winders A. D., Buell H. E., Riggs D. B., Lester G. E., Ontjes D. A. Increased rate of fractures and severe kyphosis: sequelae of living into adulthood with cystic fibrosis. Ann Intern Med. 1998 Feb 1;128(3):186–193. doi: 10.7326/0003-4819-128-3-199802010-00004. [DOI] [PubMed] [Google Scholar]
  4. Armstrong D. S., Grimwood K., Carlin J. B., Carzino R., Gutièrrez J. P., Hull J., Olinsky A., Phelan E. M., Robertson C. F., Phelan P. D. Lower airway inflammation in infants and young children with cystic fibrosis. Am J Respir Crit Care Med. 1997 Oct;156(4 Pt 1):1197–1204. doi: 10.1164/ajrccm.156.4.96-11058. [DOI] [PubMed] [Google Scholar]
  5. Armstrong D. S., Grimwood K., Carzino R., Carlin J. B., Olinsky A., Phelan P. D. Lower respiratory infection and inflammation in infants with newly diagnosed cystic fibrosis. BMJ. 1995 Jun 17;310(6994):1571–1572. doi: 10.1136/bmj.310.6994.1571. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Beardsmore C. S. Lung function from infancy to school age in cystic fibrosis. Arch Dis Child. 1995 Dec;73(6):519–523. doi: 10.1136/adc.73.6.519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Bedrossian C. W., Greenberg S. D., Singer D. B., Hansen J. J., Rosenberg H. S. The lung in cystic fibrosis. A quantitative study including prevalence of pathologic findings among different age groups. Hum Pathol. 1976 Mar;7(2):195–204. doi: 10.1016/s0046-8177(76)80023-8. [DOI] [PubMed] [Google Scholar]
  8. Boe J., Dennis J. H., O'Driscoll B. R., Bauer T. T., Carone M., Dautzenberg B., Diot P., Heslop K., Lannefors L., European Respiratory Society Task Force on the use of nebulizers European Respiratory Society Guidelines on the use of nebulizers. Eur Respir J. 2001 Jul;18(1):228–242. doi: 10.1183/09031936.01.00220001. [DOI] [PubMed] [Google Scholar]
  9. Borsje P., de Jongste J. C., Mouton J. W., Tiddens H. A. Aerosol therapy in cystic fibrosis: a survey of 54 CF centers. Pediatr Pulmonol. 2000 Nov;30(5):368–376. doi: 10.1002/1099-0496(200011)30:5<368::aid-ppul2>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  10. Bosworth D. G., Nielson D. W. Effectiveness of home versus hospital care in the routine treatment of cystic fibrosis. Pediatr Pulmonol. 1997 Jul;24(1):42–47. doi: 10.1002/(sici)1099-0496(199707)24:1<42::aid-ppul7>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  11. Brand P. L. Bronchodilators in cystic fibrosis. J R Soc Med. 2000;93 (Suppl 38):37–39. [PMC free article] [PubMed] [Google Scholar]
  12. Brown J. S., Zeman K. L., Bennett W. D. Regional deposition of coarse particles and ventilation distribution in healthy subjects and patients with cystic fibrosis. J Aerosol Med. 2001 Winter;14(4):443–454. doi: 10.1089/08942680152744659. [DOI] [PubMed] [Google Scholar]
  13. Button B. M., Heine R. G., Catto-Smith A. G., Phelan P. D., Olinsky A. Postural drainage and gastro-oesophageal reflux in infants with cystic fibrosis. Arch Dis Child. 1997 Feb;76(2):148–150. doi: 10.1136/adc.76.2.148. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Button B. M., Heine R. G., Catto-Smith A. G., Phelan P. D. Postural drainage in cystic fibrosis: is there a link with gastro-oesophageal reflux? J Paediatr Child Health. 1998 Aug;34(4):330–334. doi: 10.1046/j.1440-1754.1998.00236.x. [DOI] [PubMed] [Google Scholar]
  15. Button Brenda M., Heine Ralf G., Catto-Smith Anthony G., Olinsky Anthony, Phelan Peter D., Ditchfield Michael R., Story Ian. Chest physiotherapy in infants with cystic fibrosis: to tip or not? A five-year study. Pediatr Pulmonol. 2003 Mar;35(3):208–213. doi: 10.1002/ppul.10227. [DOI] [PubMed] [Google Scholar]
  16. Colombo John L. Long-acting bronchodilators in cystic fibrosis. Curr Opin Pulm Med. 2003 Nov;9(6):504–508. doi: 10.1097/00063198-200311000-00010. [DOI] [PubMed] [Google Scholar]
  17. Conway S. P. Impact of lung inflammation on bone metabolism in adolescents with cystic fibrosis. Paediatr Respir Rev. 2001 Dec;2(4):324–331. doi: 10.1053/prrv.2001.0167. [DOI] [PubMed] [Google Scholar]
  18. Dab I., Alexander F. The mechanism of autogenic drainage studied with flow volume curves. Monogr Paediatr. 1979;10:50–53. [PubMed] [Google Scholar]
  19. Dakin Carolyn J., Numa Andrew H., Wang He, Morton John R., Vertzyas Calypso C., Henry Richard L. Inflammation, infection, and pulmonary function in infants and young children with cystic fibrosis. Am J Respir Crit Care Med. 2002 Apr 1;165(7):904–910. doi: 10.1164/ajrccm.165.7.2010139. [DOI] [PubMed] [Google Scholar]
  20. Demont B., Escourrou P., Vinçon C., Cambas C. H., Grisan A., Odièvre M. Effets de la kinésithérapie respiratoire et des aspirations naso-pharyngées sur le reflux gastro-oesophagien chez l'enfant de 0 à 1 an, avec et sans reflux pathologique. Arch Fr Pediatr. 1991 Nov;48(9):621–625. [PubMed] [Google Scholar]
  21. Desmond K. J., Schwenk W. F., Thomas E., Beaudry P. H., Coates A. L. Immediate and long-term effects of chest physiotherapy in patients with cystic fibrosis. J Pediatr. 1983 Oct;103(4):538–542. doi: 10.1016/s0022-3476(83)80579-4. [DOI] [PubMed] [Google Scholar]
  22. Dorlöchter Ludger, Helgheim Vegard, Røksund Ola D., Rosendahl Karen, Fluge Gjermund. Shwachman-Kulczycki score and resting energy expenditure in cystic fibrosis. J Cyst Fibros. 2003 Sep;2(3):148–151. doi: 10.1016/S1569-1993(03)00060-2. [DOI] [PubMed] [Google Scholar]
  23. Doull I. J. Recent advances in cystic fibrosis. Arch Dis Child. 2001 Jul;85(1):62–66. doi: 10.1136/adc.85.1.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Döring G., Conway S. P., Heijerman H. G., Hodson M. E., Høiby N., Smyth A., Touw D. J. Antibiotic therapy against Pseudomonas aeruginosa in cystic fibrosis: a European consensus. Eur Respir J. 2000 Oct;16(4):749–767. doi: 10.1034/j.1399-3003.2000.16d30.x. [DOI] [PubMed] [Google Scholar]
  25. Döring G., Jansen S., Noll H., Grupp H., Frank F., Botzenhart K., Magdorf K., Wahn U. Distribution and transmission of Pseudomonas aeruginosa and Burkholderia cepacia in a hospital ward. Pediatr Pulmonol. 1996 Feb;21(2):90–100. doi: 10.1002/(SICI)1099-0496(199602)21:2<90::AID-PPUL5>3.0.CO;2-T. [DOI] [PubMed] [Google Scholar]
  26. Elkin S. L., Fairney A., Burnett S., Kemp M., Kyd P., Burgess J., Compston J. E., Hodson M. E. Vertebral deformities and low bone mineral density in adults with cystic fibrosis: a cross-sectional study. Osteoporos Int. 2001;12(5):366–372. doi: 10.1007/s001980170104. [DOI] [PubMed] [Google Scholar]
  27. Everard Mark L. Inhalation therapy for infants. Adv Drug Deliv Rev. 2003 Jul 18;55(7):869–878. doi: 10.1016/s0169-409x(03)00082-6. [DOI] [PubMed] [Google Scholar]
  28. Falk M., Kelstrup M., Andersen J. B., Kinoshita T., Falk P., Støvring S., Gøthgen I. Improving the ketchup bottle method with positive expiratory pressure, PEP, in cystic fibrosis. Eur J Respir Dis. 1984 Aug;65(6):423–432. [PubMed] [Google Scholar]
  29. Feigelson J., Girault F., Pecau Y. Gastro-oesophageal reflux and esophagitis in cystic fibrosis. Acta Paediatr Scand. 1987 Nov;76(6):989–990. doi: 10.1111/j.1651-2227.1987.tb17283.x. [DOI] [PubMed] [Google Scholar]
  30. Fink J. B. Aerosol device selection: evidence to practice. Respir Care. 2000 Jul;45(7):874–885. [PubMed] [Google Scholar]
  31. Flower K. A., Eden R. I., Lomax L., Mann N. M., Burgess J. New mechanical aid to physiotherapy in cystic fibrosis. Br Med J. 1979 Sep 15;2(6191):630–631. doi: 10.1136/bmj.2.6191.630. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Geiss S. K., Hobbs S. A., Hammersley-Maercklein G., Kramer J. C., Henley M. Psychosocial factors related to perceived compliance with cystic fibrosis treatment. J Clin Psychol. 1992 Jan;48(1):99–103. doi: 10.1002/1097-4679(199201)48:1<99::aid-jclp2270480114>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  33. Gibson Ronald L., Burns Jane L., Ramsey Bonnie W. Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Respir Crit Care Med. 2003 Oct 15;168(8):918–951. doi: 10.1164/rccm.200304-505SO. [DOI] [PubMed] [Google Scholar]
  34. Goss Christopher H. Airway clearance in cystic fibrosis. Respir Care. 2003 Jan;48(1):20–21. [PubMed] [Google Scholar]
  35. Grasso M. C., Button B. M., Allison D. J., Sawyer S. M. Benefits of music therapy as an adjunct to chest physiotherapy in infants and toddlers with cystic fibrosis. Pediatr Pulmonol. 2000 May;29(5):371–381. doi: 10.1002/(sici)1099-0496(200005)29:5<371::aid-ppul6>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  36. Groth S., Stafanger G., Dirksen H., Andersen J. B., Falk M., Kelstrup M. Positive expiratory pressure (PEP-mask) physiotherapy improves ventilation and reduces volume of trapped gas in cystic fibrosis. Bull Eur Physiopathol Respir. 1985 Jul-Aug;21(4):339–343. [PubMed] [Google Scholar]
  37. Gudas L. J., Koocher G. P., Wypij D. Perceptions of medical compliance in children and adolescents with cystic fibrosis. J Dev Behav Pediatr. 1991 Aug;12(4):236–242. [PubMed] [Google Scholar]
  38. Hamutcu Refika, Rowland Jon M., Horn Monica V., Kaminsky Cornelia, MacLaughlin Eithne F., Starnes Vaughn A., Woo Marlyn S. Clinical findings and lung pathology in children with cystic fibrosis. Am J Respir Crit Care Med. 2002 Apr 15;165(8):1172–1175. doi: 10.1164/ajrccm.165.8.2104090. [DOI] [PubMed] [Google Scholar]
  39. Hardy K. A., Wolfson M. R., Schidlow D. V., Shaffer T. H. Mechanics and energetics of breathing in newly diagnosed infants with cystic fibrosis: effect of combined bronchodilator and chest physical therapy. Pediatr Pulmonol. 1989;6(2):103–108. doi: 10.1002/ppul.1950060209. [DOI] [PubMed] [Google Scholar]
  40. Hart Nicholas, Polkey Michael I., Clément Annick, Boulé Michèle, Moxham John, Lofaso Frédéric, Fauroux Brigitte. Changes in pulmonary mechanics with increasing disease severity in children and young adults with cystic fibrosis. Am J Respir Crit Care Med. 2002 Jul 1;166(1):61–66. doi: 10.1164/rccm.2112059. [DOI] [PubMed] [Google Scholar]
  41. Hebestreit A., Kersting U., Basler B., Jeschke R., Hebestreit H. Exercise inhibits epithelial sodium channels in patients with cystic fibrosis. Am J Respir Crit Care Med. 2001 Aug 1;164(3):443–446. doi: 10.1164/ajrccm.164.3.2007168. [DOI] [PubMed] [Google Scholar]
  42. Henderson R. C., Specter B. B. Kyphosis and fractures in children and young adults with cystic fibrosis. J Pediatr. 1994 Aug;125(2):208–212. doi: 10.1016/s0022-3476(94)70194-6. [DOI] [PubMed] [Google Scholar]
  43. Jaffé A., Bush A. Cystic fibrosis: review of the decade. Monaldi Arch Chest Dis. 2001 Jun;56(3):240–247. [PubMed] [Google Scholar]
  44. Khan T. Z., Wagener J. S., Bost T., Martinez J., Accurso F. J., Riches D. W. Early pulmonary inflammation in infants with cystic fibrosis. Am J Respir Crit Care Med. 1995 Apr;151(4):1075–1082. doi: 10.1164/ajrccm/151.4.1075. [DOI] [PubMed] [Google Scholar]
  45. Kruhlak R. T., Jones R. L., Brown N. E. Regional air trapping before and after exercise in young adults with cystic fibrosis. West J Med. 1986 Aug;145(2):196–199. [PMC free article] [PubMed] [Google Scholar]
  46. Lannefors L., Wollmer P. Mucus clearance with three chest physiotherapy regimes in cystic fibrosis: a comparison between postural drainage, PEP and physical exercise. Eur Respir J. 1992 Jun;5(6):748–753. [PubMed] [Google Scholar]
  47. Levy J. Antibiotic activity in sputum. J Pediatr. 1986 May;108(5 Pt 2):841–846. doi: 10.1016/s0022-3476(86)80755-7. [DOI] [PubMed] [Google Scholar]
  48. Long Frederick R., Williams Roger S., Castile Robert G. Structural airway abnormalities in infants and young children with cystic fibrosis. J Pediatr. 2004 Feb;144(2):154–161. doi: 10.1016/j.jpeds.2003.09.026. [DOI] [PubMed] [Google Scholar]
  49. Mackenzie C. F., Shin B., Hadi F., Imle P. C. Changes in total lung/thorax compliance following chest physiotherapy. Anesth Analg. 1980 Mar;59(3):207–210. [PubMed] [Google Scholar]
  50. Maffessanti M., Candusso M., Brizzi F., Piovesana F. Cystic fibrosis in children: HRCT findings and distribution of disease. J Thorac Imaging. 1996 Winter;11(1):27–38. doi: 10.1097/00005382-199601110-00002. [DOI] [PubMed] [Google Scholar]
  51. Malfroot A., Dab I. New insights on gastro-oesophageal reflux in cystic fibrosis by longitudinal follow up. Arch Dis Child. 1991 Nov;66(11):1339–1345. doi: 10.1136/adc.66.11.1339. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. McDonnell T., McNicholas W. T., FitzGerald M. X. Hypoxaemia during chest physiotherapy in patients with cystic fibrosis. Ir J Med Sci. 1986 Oct;155(10):345–348. doi: 10.1007/BF02960715. [DOI] [PubMed] [Google Scholar]
  53. McIlwaine P. M., Wong L. T., Peacock D., Davidson A. G. Long-term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis. J Pediatr. 1997 Oct;131(4):570–574. doi: 10.1016/s0022-3476(97)70064-7. [DOI] [PubMed] [Google Scholar]
  54. Menkes H., Britt J. Physical therapy rationale for physical therapy. Am Rev Respir Dis. 1980 Nov;122(5 Pt 2):127–131. doi: 10.1164/arrd.1980.122.5P2.127. [DOI] [PubMed] [Google Scholar]
  55. NOMENCLATURE of broncho-pulmonary anatomy; an international nomenclature accepted by the Thoracic Society. Thorax. 1950 Sep;5(3):222–228. doi: 10.1136/thx.5.3.222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Nixon G. M., Armstrong D. S., Carzino R., Carlin J. B., Olinsky A., Robertson C. F., Grimwood K., Wainwright Claire. Early airway infection, inflammation, and lung function in cystic fibrosis. Arch Dis Child. 2002 Oct;87(4):306–311. doi: 10.1136/adc.87.4.306. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Nixon P. A., Orenstein D. M., Kelsey S. F. Habitual physical activity in children and adolescents with cystic fibrosis. Med Sci Sports Exerc. 2001 Jan;33(1):30–35. doi: 10.1097/00005768-200101000-00006. [DOI] [PubMed] [Google Scholar]
  58. O'Neill S., McCarthy D. S. Postural relief of dyspnoea in severe chronic airflow limitation: relationship to respiratory muscle strength. Thorax. 1983 Aug;38(8):595–600. doi: 10.1136/thx.38.8.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. O'Riordan T. G. Inhaled antimicrobial therapy: from cystic fibrosis to the flu. Respir Care. 2000 Jul;45(7):836–845. [PubMed] [Google Scholar]
  60. Oberwaldner B. Physiotherapy for airway clearance in paediatrics. Eur Respir J. 2000 Jan;15(1):196–204. doi: 10.1183/09031936.00.15119600. [DOI] [PubMed] [Google Scholar]
  61. Oermann C. M., Swank P. R., Sockrider M. M. Validation of an instrument measuring patient satisfaction with chest physiotherapy techniques in cystic fibrosis. Chest. 2000 Jul;118(1):92–97. doi: 10.1378/chest.118.1.92. [DOI] [PubMed] [Google Scholar]
  62. Orenstein David M. Heads up! clear those airways! Pediatr Pulmonol. 2003 Mar;35(3):160–161. doi: 10.1002/ppul.10228. [DOI] [PubMed] [Google Scholar]
  63. Orenstein S. R. Gastroesophageal reflux. Curr Probl Pediatr. 1991 May-Jun;21(5):193–241. doi: 10.1016/0045-9380(91)90066-t. [DOI] [PubMed] [Google Scholar]
  64. Orenstein S. R., Whitington P. F. Positioning for prevention of infant gastroesophageal reflux. J Pediatr. 1983 Oct;103(4):534–537. doi: 10.1016/s0022-3476(83)80578-2. [DOI] [PubMed] [Google Scholar]
  65. Parasa R. B., Maffulli N. Musculoskeletal involvement in cystic fibrosis. Bull Hosp Jt Dis. 1999;58(1):37–44. [PubMed] [Google Scholar]
  66. Phillips G. E., Pike S. E., Rosenthal M., Bush A. Holding the baby: head downwards positioning for physiotherapy does not cause gastro-oesophageal reflux. Eur Respir J. 1998 Oct;12(4):954–957. doi: 10.1183/09031936.98.12040954. [DOI] [PubMed] [Google Scholar]
  67. Prasad S. A., Main E. Finding evidence to support airway clearance techniques in cystic fibrosis. Disabil Rehabil. 1998 Jun-Jul;20(6-7):235–246. doi: 10.3109/09638289809166734. [DOI] [PubMed] [Google Scholar]
  68. Pryor J. A., Webber B. A., Hodson M. E. Effect of chest physiotherapy on oxygen saturation in patients with cystic fibrosis. Thorax. 1990 Jan;45(1):77–77. doi: 10.1136/thx.45.1.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
  69. Ranganathan Sarath C., Bush Andrew, Dezateux Carol, Carr Siobhan B., Hoo Ah-Fong, Lum Sooky, Madge Su, Price John, Stroobant John, Wade Angie. Relative ability of full and partial forced expiratory maneuvers to identify diminished airway function in infants with cystic fibrosis. Am J Respir Crit Care Med. 2002 Nov 15;166(10):1350–1357. doi: 10.1164/rccm.2202041. [DOI] [PubMed] [Google Scholar]
  70. Reisman J. J., Rivington-Law B., Corey M., Marcotte J., Wannamaker E., Harcourt D., Levison H. Role of conventional physiotherapy in cystic fibrosis. J Pediatr. 1988 Oct;113(4):632–636. doi: 10.1016/s0022-3476(88)80370-6. [DOI] [PubMed] [Google Scholar]
  71. Rose J., Jay S. A comprehensive exercise program for persons with cystic fibrosis. J Pediatr Nurs. 1986 Oct;1(5):323–334. [PubMed] [Google Scholar]
  72. Ross J., Gamble J., Schultz A., Lewiston N. Back pain and spinal deformity in cystic fibrosis. Am J Dis Child. 1987 Dec;141(12):1313–1316. [PubMed] [Google Scholar]
  73. Rubin Bruce K., Fink James B. The delivery of inhaled medication to the young child. Pediatr Clin North Am. 2003 Jun;50(3):717–731. doi: 10.1016/s0031-3955(03)00049-x. [DOI] [PubMed] [Google Scholar]
  74. Salh W., Bilton D., Dodd M., Webb A. K. Effect of exercise and physiotherapy in aiding sputum expectoration in adults with cystic fibrosis. Thorax. 1989 Dec;44(12):1006–1008. doi: 10.1136/thx.44.12.1006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  75. Scott R. B., O'Loughlin E. V., Gall D. G. Gastroesophageal reflux in patients with cystic fibrosis. J Pediatr. 1985 Feb;106(2):223–227. doi: 10.1016/s0022-3476(85)80291-2. [DOI] [PubMed] [Google Scholar]
  76. Stanghelle J. K., Skyberg D., Haanaes O. C. Eight-year follow-up of pulmonary function and oxygen uptake during exercise in 16-year-old males with cystic fibrosis. Acta Paediatr. 1992 Jun-Jul;81(6-7):527–531. doi: 10.1111/j.1651-2227.1992.tb12288.x. [DOI] [PubMed] [Google Scholar]
  77. Stringer D. A., Sprigg A., Juodis E., Corey M., Daneman A., Levison H. J., Durie P. R. The association of cystic fibrosis, gastroesophageal reflux, and reduced pulmonary function. Can Assoc Radiol J. 1988 Jun;39(2):100–102. [PubMed] [Google Scholar]
  78. Tattersall R., Walshaw M. J. Posture and cystic fibrosis. J R Soc Med. 2003;96 (Suppl 43):18–22. [PMC free article] [PubMed] [Google Scholar]
  79. Tepper R. S. Assessment of the respiratory status of infants and toddlers with cystic fibrosis. J Pediatr. 1998 Mar;132(3 Pt 1):380–381. doi: 10.1016/s0022-3476(98)70002-2. [DOI] [PubMed] [Google Scholar]
  80. Tepper R. S., Hiatt P. W., Eigen H., Smith J. Total respiratory system compliance in asymptomatic infants with cystic fibrosis. Am Rev Respir Dis. 1987 May;135(5):1075–1079. doi: 10.1164/arrd.1987.135.5.1075. [DOI] [PubMed] [Google Scholar]
  81. Tepper R. S., Montgomery G. L., Ackerman V., Eigen H. Longitudinal evaluation of pulmonary function in infants and very young children with cystic fibrosis. Pediatr Pulmonol. 1993 Aug;16(2):96–100. doi: 10.1002/ppul.1950160204. [DOI] [PubMed] [Google Scholar]
  82. Thomas J., Cook D. J., Brooks D. Chest physical therapy management of patients with cystic fibrosis. A meta-analysis. Am J Respir Crit Care Med. 1995 Mar;151(3 Pt 1):846–850. doi: 10.1164/ajrccm/151.3_Pt_1.846. [DOI] [PubMed] [Google Scholar]
  83. Tiddens Harm A. W. M. Detecting early structural lung damage in cystic fibrosis. Pediatr Pulmonol. 2002 Sep;34(3):228–231. doi: 10.1002/ppul.10134. [DOI] [PubMed] [Google Scholar]
  84. Vandenplas Y., Diericx A., Blecker U., Lanciers S., Deneyer M. Esophageal pH monitoring data during chest physiotherapy. J Pediatr Gastroenterol Nutr. 1991 Jul;13(1):23–26. doi: 10.1097/00005176-199107000-00004. [DOI] [PubMed] [Google Scholar]
  85. Vandenplas Y., Goyvaerts H., Helven R., Sacre L. Gastroesophageal reflux, as measured by 24-hour pH monitoring, in 509 healthy infants screened for risk of sudden infant death syndrome. Pediatrics. 1991 Oct;88(4):834–840. [PubMed] [Google Scholar]
  86. Vinocur C. D., Marmon L., Schidlow D. V., Weintraub W. H. Gastroesophageal reflux in the infant with cystic fibrosis. Am J Surg. 1985 Jan;149(1):182–186. doi: 10.1016/s0002-9610(85)80030-1. [DOI] [PubMed] [Google Scholar]
  87. Wallis C., Prasad A. Who needs chest physiotherapy? Moving from anecdote to evidence. Arch Dis Child. 1999 Apr;80(4):393–397. doi: 10.1136/adc.80.4.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  88. Weller P. H. Implications of early inflammation and infection in cystic fibrosis: a review of new and potential interventions. Pediatr Pulmonol. 1997 Aug;24(2):143–161. doi: 10.1002/(sici)1099-0496(199708)24:2<143::aid-ppul14>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  89. Wong J. W., Keens T. G., Wannamaker E. M., Crozier D. N., Levison H., Aspin N. Effects of gravity on tracheal mucus transport rates in normal subjects and in patients with cystic fibrosis. Pediatrics. 1977 Aug;60(2):146–152. [PubMed] [Google Scholar]
  90. Wood R. E., Wanner A., Hirsch J., Farrell P. M. Tracheal mucociliary transport in patients with cystic fibrosis and its stimulation by terbutaline. Am Rev Respir Dis. 1975 Jun;111(6):733–738. doi: 10.1164/arrd.1975.111.6.733. [DOI] [PubMed] [Google Scholar]
  91. Zach M. S., Oberwaldner B. Chest physiotherapy--the mechanical approach to antiinfective therapy in cystic fibrosis. Infection. 1987;15(5):381–384. doi: 10.1007/BF01647750. [DOI] [PubMed] [Google Scholar]
  92. Zach M., Oberwaldner B., Häusler F. Cystic fibrosis: physical exercise versus chest physiotherapy. Arch Dis Child. 1982 Aug;57(8):587–589. doi: 10.1136/adc.57.8.587. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES