Rodriguez Hortal 2016.

Methods	RCT. Parallel design. Duration: both interventions given 2x daily for 60 min for 3 months.
Participants	32 participants with CF. Mean (SD) age: 31 (10) years. Moderate to severe lung disease. Baseline FEV₁ % predicted mean (SD) (range): 47% (14) (22% to 69%). Baseline FVC % predicted mean (SD): 69% (13).%.
Interventions	Intervention 1: treatment including bronchodilators; AD with HTS for 15 min; then NIV with face mask; FET/huffing from mid to low lung volume. Intervention 2: treatment including bronchodilators; AD with HTS for 15 min; then PEP with mask; FET/huffing from mid to low lung volume. NIV: IPAP 20 cm H₂O minimum; EPAP 10 cm H₂O. PEP: 10 breaths with 10 to 20 cm H₂O resistance.
Outcomes	Lung function (FEV₁; FVC; LCI), 6MWT, PaCO₂, sputum culture, inflammatory blood markers.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	States randomised but no further details given.
Allocation concealment (selection bias)	Low risk	States opaque envelopes were used to assign to 1 of 2 groups.
Blinding (performance bias and detection bias) All outcomes	Low risk	Pulmonary lab technicians blinded to physiotherapy treatment took lung function readings; research nurses blinded to treatment took vital signs; 6MWT was performed by the physiotherapist although it is unclear if the physiotherapist conducting the 6MWT is blinded to treatment allocation.
Incomplete outcome data (attrition bias) All outcomes	Low risk	All participants were accounted for.
Selective reporting (reporting bias)	Low risk	It is stated that inflammatory blood markers, blood gases and sputum analysis monthly was non‐significant compared to baseline (data not reported); FRC did not change in either group (data not reported). All other outcome measures were reported.
Other bias	Low risk	Methods of statistical analysis were reported.