LONG-TERM COMPARATIVE TRIAL OF CONVENTIONAL POSTURAL DRAINAGE AND PERCUSSION VERSUS POSITIVE EXPIRATORY PRESSURE PHYSIOTHERAPY IN THE TREATMENT OF CYSTIC-FIBROSIS

We report the results of a long-term comparative trial of physiotherap y by the positive expiratory pressure (PEP) technique with a PEP mask (Astra Meditec) versus conventional postural drainage and percussion ( PD&P). Forty patients, ages 6 to 17 years, with Shwachman scores betwe en 52 and 93, attending the cystic fibrosis clinic were enrolled in th e study and randomly assigned to one of two groups. Group A (control) continued to perform physiotherapy by using PD&P for a 1-year period, whereas patients assigned to group B performed physiotherapy with the PEP technique for the same period. Compliance with physiotherapy was c losely monitored for both groups throughout the study. Clinical status and pulmonary function (forced vital capacity [FVC], FEV1, and FEF25- 75) were measured at 3-month intervals. Group B (PEP) demonstrated imp roved pulmonary function in all parameters as measured by change in pe rcent predicted value for age, gender, and height. The changes in pulm onary function over the study period were: FVC, +6.57; FEV1, +5.98; an d FEF25-75, +3.32. This improvement was significantly different from t hat of group A (PD&P) whose pulmonary function declined in all paramet ers (FVC, -2.17; FEV1, -2.28; FEF25-75, -0.24). The differences betwee n treatment groups were statistically significant for the changes in F VC (p = 0.02) and FEV1 (p = 0.04). Our results indicate that for our p atients with cystic fibrosis, pulmonary physiotherapy with the PEP tec hnique was superior to conventional physiotherapy with the PD&P techni que.