Evaluation of the Literature on the Effectiveness of Physical Therapy Modalities in the Management of Children With Cystic Fibrosis

The purpose of this paper was to critically appraise the literature on the effectiveness of various physical therapy modalities in the treatment of children with cystic fibrosis. The modalities evaluated were: conventional physical therapy (percussion, vibration, and postural drainage), exercise, forced expiratory technique (FET), positive expiratory pressure (PEP) mask, autogenic drainage, and coughing. Studies were evaluated and classified according to modified Sackett's level of evidence. Using pulmonary function test results as outcome measures there was evidence to indicate that conventional physical therapy, positive expiratory pressure mask, and exercise are effective in the management of individuals with cystic fibrosis in the chronic state of the disease. One study indicated that the use of forced expiratory technique alone resulted in a deterioration in pulmonary function test results during the chronic state. There was no evidence to support or refute the use of autogenic drainage. Examples of the physiotherapeutic modalities that require additional investigation and suggestions for improving the research designs of future studies and with this population are provided.