Date of Graduation

8-15-2009

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Mark Pedemonte, MD

Second Advisor

Rob Rosenow PharmD, OD

Third Advisor

Annjanette Sommers MS, PA-C

Abstract

OBJECTIVE: To systematically review the evidence comparing the chest physiotherapy (CPT) with other forms of non-pharmacological airway clearance therapy (ACT) in order to determine what is the best intervention which preserves the pulmonary function (PF) in cystic fibrosis (CF) patients.

METHODS: MEDLINE and CINAHL were used to search for randomized studies limited to human, published in English language between 1980 and May 2009. Key terms included “cystic fibrosis,” “chest physiotherapy,” “chest physical therapy,” “postural drainage,” “airway clearance therapy,” and “pulmonary function”. A list of summary tables was developed to assess collected information for the conclusion.

RESULTS: Eight studies met the selection criteria presenting the results or discussion of pulmonary function (PF) in ACT management for the CF patients. The review found no significant changes in pulmonary function compared between chest physiotherapy (CPT) with other airway clearance (ACT) techniques. There were inconsistent and limited clinical evidence to prove neither CPT nor other ACT techniques were an effective method preserving the pulmonary function (PF) among cystic fibrosis (CF) patients.

CONCLUSION: This review did not reveal the most effective ACT form in preserving the PF in CF. Further multi-center, long term, appropriately designed clinical studies are suggested to determine the most effective form of airway clearance therapy that preserves the pulmonary function (PF) in cystic fibrosis (CF) patients.

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