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I have a question concerning physiotherapy with a patient with cystic fibrosis. What actions are needed here? Can the patient do it at home? What effect has it on the patient, apart from clearing the airways?
Thank you.
Dear reader,

Thank you for this nice question. Physiotherapy for cystic fibrosis is nowadays more than just the respiratory therapy. It means:

- Inhalation Therapy
- Airway clearance Therapy
- Mobilisation
- Exercise Training
Patients spend everyday a lot of time on these therapies, sometimes even several hours depending to the disease severity. Therefore it is very important that the patient is well supported and coached by his or her physiotherapist.

Nevertheless it is very important that the patient is able to perform independently his therapy without being dependent on his or her therapist.
There is no standard therapy for cystic fibrosis patients. Therapy should be individualized according to the patient, his condition and patients expectations.

Inhalation therapy:
This includes everything concerning nebulisations, inhalations with dry powder inhalers. It is important that the patient has the correct material for inhalation, adapted to the disease severity, age and the practical choice. The CF reference center can help in that choice.

Airway Clearance Therapy:
For airway clearance therapy, it is important to choose the technique that fits the patient. There should be considerable time spent on learning the different airway clearance therapies, because these techniques are dependent on age. A toddler can’t do his therapy independently as adolescents should work towards more independency.
Before starting the actual airway clearance, it is important to make sure that the upper airways are clean. This can be done by blowing the nose properly or clear the nose by using a nasal washing system.

It is important that each patient learns to work with several helping tools (such as PEP and flutter) in order to make a correct choice of the tools according to the needs of the patient. Especially for young children, it is important to vary. Those helping tools allow the patient to perform the therapy on an independent and daily basis.
The collection of secretions should be the main objective of the airway clearance therapy.


Besides airway clearance therapy, it is also important to keep the chest mobility as normal as possible. That way the respiratory muscles can give an optimal contribution during drainage and breathing techniques.
These exercises can be taught in many ways.
In this aspect of the therapy, it is important that a physiotherapist gives regularly feedback and adapts the therapy to the individual needs of the patient. The patient often gets an exercise program to perform this independently at home.

Exercise training:

Condition building or exercise training is important for everyone, and also for CF patients. More, it is shown that doing sports has a beneficial effect on the mobilization of secretions in CF patients and it slows down the decline of the lung function. The best kind of training to be given is a topic already answered on the E-corn. Have a look through these answers.

Doing sports is in the first place a school happening, in the family or at the club, certainly not only with the physiotherapist. For very ill patients exercising is difficult and help and supervision of a physiotherapist is then recommended.

Best regards,
Prof. Kris de Boeck