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Effects of a supervised, outpatient exercise and physiotherapy programme in children with cystic fibrosis

Donald Urquhart1, Zoe Sell, Elaine Dhouieb

  • 1Department of Paediatric Respiratory Medicine, Royal Hospital for Sick Children, Edinburgh, UK. don.urquhart@luht.scot.nhs.uk

Pediatric Pulmonology
|May 4, 2012
PubMed

Insights

A year-long supervised exercise and physiotherapy program for children with cystic fibrosis (CF) significantly reduced intravenous antibiotic use and improved exercise capacity. The program also enhanced quality of life, showing a trend toward reduced lung function decline in CF patients.

Area of Science:

  • Pediatric Pulmonology
  • Rehabilitation Medicine
  • Clinical Exercise Physiology

Background:

  • Children with cystic fibrosis (CF) often experience reduced exercise capacity and frequent exacerbations requiring intravenous (IV) antibiotics.
  • Previous studies suggest outpatient exercise and physiotherapy may benefit CF patients.
  • The long-term effects of supervised programs on key CF outcomes require further investigation.

Purpose of the Study:

  • To evaluate the impact of a year-long supervised outpatient exercise and physiotherapy program on children with CF.
  • To assess changes in exercise capacity, lung function, quality of life, and IV antibiotic requirements.

Main Methods:

  • 12 children with CF (age ≥10 years) with ≥4 IV antibiotic courses in 2009 participated.
  • Participants engaged in fortnightly supervised exercise and physiotherapy sessions throughout 2010.
  • They also performed home exercise 3x/week and additional physiotherapy when unwell.

Main Results:

  • A significant reduction in IV antibiotic days from 60 to 50 days (P=0.02) was observed.
  • Exercise capacity, measured by Modified Shuttle Test (MST) distance and level attained, significantly improved (P=0.04).
  • Quality of life scores (CFQ-UK) significantly improved across physical, emotional, treatment, and respiratory domains (P≤0.002).

Conclusions:

  • Supervised outpatient exercise and physiotherapy programs improve quality of life and exercise tolerance in children with CF.
  • These programs are associated with reduced IV antibiotic use and a trend toward slower lung function decline.
  • The cost savings from reduced IV antibiotic use have implications for healthcare service planning.

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