EFFECTS OF FLUTTER AND PEP MASK PHYSIOTHERAPY ON SYMPTOMS AND LUNG-FUNCTION IN CHILDREN WITH CYSTIC-FIBROSIS

Recently, the Butter was introduced as a new device to improve sputum expectoration, Preliminary data suggested a significant improvement in expectoration and lung function during Butter treatment in patients w ith cystic fibrosis (CF), The aim of the present study was to compare the effects of the Butter and the positive expiratory pressure (PEP) m ask on symptoms and lung function in children with CF, In a crossover randomized study 22 patients with CF (mean age 12 yrs, range 7-17 yrs) performed physiotherapy using either the Butter or the PEP mask twice a day during two treatment periods of 2 weeks, separated by a one wee k wash-out period, in a random sequence. Lung function parameters (pea k expiratory flow, forced vital capacity (FVC), forced expiratory volu me in one second, maximal midexpiratory flow, maximal expiratory Bow a t 25% of FVC, thoracic gas volume, total lung capacity, residual volum e/total lung capacity, airway resistance and specific airway conductan ce) and changes in transcutaneous oxygen haemoglobin saturation were a ssessed before and after the first supervised session and at the end o f each treatment period. Throughout the study peak flow was measured a nd symptoms were scored daily, No significant changes in any lung func tion parameter occurred after a single session or after 2 weeks of phy siotherapy with either method. There was no difference in acceptabilit y and subjective efficacy. In conclusion, any superiority of the Butte r over the positive expiratory pressure mask technique for expectorati on could not be confirmed during 2 weeks of daily treatment in childre n with cystic fibrosis. Both methods are well accepted by children and do not change lung function. Long-term comparison of both methods, in cluding expectoration measurements, seems to be required for further e valuation of the potential success of physiotherapy in cystic fibrosis .