The Breath project (Project Number: 2022-1-PL01-KA220-HED-000089283) has been Co-funded by the European Union. Views and opinions expressed are however those of the author or authors only and do not necessarily reflect those of the European Union or the Foundation for the Development of the Education System. Neither the European Union nor the entity providing the grant can be held responsible for them.

Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial

Choose one of the available languages:
Institution
Istanbul University‐Cerrahpaşa,
Institution Typology
University
Country
Turkey
Description
Intervention design: Participants continued their routine physiotherapy and rehabilitation programs as planned by the physiotherapist, including patient and family education, airway clearance techniques (breathing exercises, active breathing technique, oscillator devices) and physical activity counseling.
People involved: Thirty patients, Expiratory muscle training (EMT) group, n=15 Control group, n=15
Barriers identified: The effect of physiotherapy and rehabilitation programs on quality of life (QoL) in CF is unclear in the literature. However, in this study, all the patients in the groups rated their changes as unchanged or better. No one reported a worsening of their situation.
Sustainability: A specific 6-week expiratory muscle training program improved peak cough flow (PFC), maximum expiratory pressure (MEP) and quality of life in CF patients. In addition, maximum inspiratory pressure (MIP) and functional exercise capacity increased in the expiratory muscle training group. The training program can be applied both in hospital and at home.
Transferability: The approach can be adapted to other respiratory diseases or conditions and in other countries or demographic groups.
Disease
Cystic Fibrosis
Activity level
Medium
Activity Typology
Rehabilitation section-based activities, Home-based activities
Motivation Tools
Not available
Innovation
Coughing is an important defense and airway clearance mechanism for the removal of thick and viscous secretions in cystic fibrosis (CF). The main aim of this study was to investigate the effect of expiratory muscle training (EMT) on peak cough flow (PCF) and, secondly, on respiratory muscle functions, functional exercise capacity and quality of life (QoL) in CF.
Evaluation System
Both groups were trained with the EMT protocol, which involved twice a day, at least 5 days a week, for 6 weeks. The training intensity in the training group was 30% of the maximum expiratory pressure (MEP). In the control group, the lowest pressure (5 cmH2O) was maintained. The primary endpoint was PCF. The secondary endpoints were MEP, maximum inspiratory pressure (MIP), spirometric measurements, six-minute walk distance (6MWD) and QoL (Cystic Fibrosis Questionnaire - Revised). Changes in PCF (p = 0.041) and MEP (p = 0.003) were higher in the training group than in the simulated group. In addition, treatment weight (p = 0.008), digestive symptoms (p = 0.019) and vitality (p = 0.042) in QoL improved more in the training group. MIP (p = 0.028) and 6MWD (p = 0.035) changed significantly only in the training group. Spirometry measurements did not change (p > 0.05).
Assessment
Expiratory muscle training can improve peak cough flow, maximum expiratory pressure, treatment weight, digestive symptoms and Quality of Life vitality domains in cystic fibrosis patients.
References
Emirza, C., Aslan, G. K., Kilinc, A. A., & Cokugras, H. (2021). Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial. Pediatric Pulmonology, 56(5), 939-947. doi.org/10.1002/ppul.25259" target="_blank">doi.org/10.1002/ppul.25259" target="_blank">doi.org/10.1002/ppul.25259
Log in to comment >>

Bruno Ferreira, ESS - IPS - Portugal (PT)
Expiratory muscle training enhances airway clearance and quality of life in CF patients, showing promise for routine integration. Future studies could explore long-term effects and optimize training intensity for sustained benefits.