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Physical activity and exercise training in cystic fibrosis
Thomas Radtke1, Sherie Smith2, Sarah J Nevitt3
1Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
The Cochrane Database of Systematic Reviews
|August 9, 2022
Summary
Regular physical activity likely improves exercise capacity in cystic fibrosis (CF) patients over six months. However, evidence suggests minimal impact on lung function and quality of life, with rare adverse effects.
Area of Science:
- Pulmonary Medicine
- Exercise Physiology
- Clinical Trials
Background:
- Physical activity is increasingly recognized as a key component of comprehensive care for individuals with cystic fibrosis (CF).
- This review is an updated analysis of the existing evidence on physical activity interventions for CF patients.
Purpose of the Study:
- To evaluate the impact of physical activity interventions on exercise capacity (peak oxygen uptake).
- To assess effects on lung function (forced expiratory volume in one second - FEV1).
- To determine the influence on health-related quality of life (HRQoL) and other patient-relevant outcomes in individuals with CF.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs.
- Searched major databases including Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register, clinicaltrials.gov, and WHO ICTRP.
- Included 24 RCTs involving 875 participants with CF, varying in age, disease severity, intervention duration, and supervision levels.
Main Results:
- Physical activity interventions lasting over six months likely improve exercise capacity (moderate-certainty evidence).
- Little to no effect was observed on lung function (FEV1) and HRQoL (physical functioning, respiratory domain) (low-certainty evidence).
- No significant differences were found in pulmonary exacerbations, diabetic control, or adverse events between physical activity and control groups.
Conclusions:
- Longer-term physical activity (≥6 months) shows moderate evidence for improving exercise capacity in CF patients.
- Current evidence indicates minimal benefits for lung function and HRQoL, with low certainty.
- Physical activity is generally safe for individuals with CF, and its inclusion in care is encouraged, though optimal program design requires further research.
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