Cystic fibrosis: comparison between Conventional Chest Physical Therapy and Positive Expiratory Pressure in hospitalized patients

Objective To compare the efficacy of Conventional Chest Physical Therapy with Positive Expiratory Pressure in the treatment of cystic fibrosis patients during hospital treatment of exacerbation. Methods Randomized clinical trial with 29 patients at the Hospital de Clinicas de Porto Alegre . Thirteen patients were randomly assigned to Group A (Positive Expiratory Pressure) in which the seated patient went through 15 breathing cycles using a mask with a positive end-expiratory pressure of 13 cmH2O, followed by huffing without the mask along with coughing and expectoration. This sequence was repeated 7 times during 30 minutes. Sixteen patients were included in group B (Conventional Chest Physical Therapy) where patients assumed five postural drainage positions. In each position, the chest was submitted to manual clapping for three minutes associated with vibration, deep breathing, huffing, coughing and expectoration. Each position was maintained for five to seven minutes for a total of 30 minutes, twice daily. The patients were evaluated before and after the treatment using pulmonary function tests, peak expiratory flow, measurement of the arterial oxyhemoglobin saturation and determination of the Shwachmann radiographic score. Results In a comparison of the outcomes of the two groups using the Student t test and analysis of covariance, there were no statistically significant differences between the two groups with respect to outcome ( p <0.05). Conclusion The results indicated no differences between the techniques evaluated. Further studies are necessary since PEP gives more autonomy to the patients. Indexing terms : cystic fibrosis; conventional chest physical therapy; positive-pressure respiration.