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cystic fibrosis

Essence of question: Why do therapeutic approches differ so much: in some countries they use more autogenic drainage (Scandinavia) in some more "the vest" (USA, Lithuania)?
Dear Questioner,
existing difference between physiotherapeutic techniques used in various contries can be due to cultural differences:when using the Vest, there is no physical contact between therapist and patient, whereas autogenic drainage requires much closer physical contact between therapist and patient.
Up to now we are not aware of a comparative study of autogenic drainage and the Vest.
Sigitas Dumcius
Detailed information can be found in the paper by Flume et al. 2009 in Respiratory Care (Vol 54(4):522-537 "Cystic Fibrosis Pulmonary Guidelines: Airway Clearance Therapies").
In summary, in this paper, available data was reviewed and there are some trials comparing the vest (high-frequency chest compression) with percussion and postural drainage, PEP, active cycle of breathing techniques and with oscillatory PEP), but indeed no study compared the vest and autogenic drainage. The other studies could not clearly prove one therapy being superior to the others. Therefore, the authors conclude:
"There are no airway clearance technique demonstrated to be superior to others, so the prescription of airway clearance techniques should be individualized. The individual circumstances for each patient will help dictate the choice of airway clearance regimen. There are advantages and disadvantages of each of the therapeutic options and decisions regarding prescription of airway clearance may include age of the patient, patient preference, severity of disease, availability of a partner and observed efficacy based on patient reporting and objective measures."
D. d'Alquen