The short and long term role and effectiveness of physiotherapy in children with Cystic Fibrosis

Hypothesis and purpose: Physiotherapy is one of the main interventions that contribute to quality of life improvement for these patients. The purpose of this work is to asses the physiotherapy efficiency in infants. Method: The study was conducted in the Paediatric Clinic II and in Romanian National Cystic Fibrosis Centre Timisoara and evaluations were made at the “Politehnica” University of Timisoara. Study group included 15 patients (10 male, 5 female), aged between 2 months and 3 years. Long-term clinical evaluation and evaluation during exacerbations included: general clinical condition and nutritional status evaluation, cough character, presence of dyspnoea and pulmonary physical signs (wheezing, rales). Patients also benefit of bacteriological examination of sputum or hipofaringian aspirate, radiological examination and quantification of changes severity with “Norman and Chrispin” score, CT and pulse oximetry. Physiotherapy treatment was established according to the diagnosis time and the clinical condition of patients. Results: At discharge, 80% of the patients had good overall condition, including those infected with persistent Staphylococcus aureus. Nutritional status improved in all patients and coughing disappeared in 46% of the cases. Bacterial culture remained positive in 40% of the patients. Oxygen saturation became normal after physiotherapy, even in patients with persistent infection and Norman and Chrispin score improved and sterilization in patients with Staphylococcus aureus was successful in 42% of cases. Conclusions: The results of this study highlight the importance of short term physiotherapy in improving clinical and nutritional status and the importance of clearance techniques in staphylococcal infection sterilization and Chrispin-Norman score improving. Assessment of the long term (one year) physiotherapy effectiveness, showed the importance of physiotherapy in reducing the number of exacerbations and therefore the number of readmissions, especially for the uninfected subjects.