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Cystic fibrosis (CF) lung disease is characterised by reduced mucus clearance, resulting in retention of thick mucus, creating a nidus for chronic infection and progressive lung damage. A cornerstone of the medical management of CF lung disease is daily airway clearance therapy (ACT), tailored to the individual, such as active cycle of breathing technique (ACBT), autogenic drainage, positive expiratory pressure (PEP) and oscillating PEP devices, postural drainage, percussion and high-frequency chest wall oscillations.1 There is widespread agreement among people with CF and healthcare professionals that exercise may also improve airway clearance2 and many people with CF already use exercise as a substitute for ACT.3 Whether exercise is a satisfactory substitute for traditional ACTs in people with CF has been identified as a top 10 research priority,4 yet none of the many systematic reviews on the various ACTs have answered this question, as in the five systematic reviews5 only one study was eligible for inclusion, and the systematic review on exercise training did not specifically address airway clearance.6 People with CF are encouraged to regularly exercise,1 due to the known benefits on exercise capacity and potential improvements in lung function and quality of life.6 If exercise could adequately replace traditional ACTs for people with CF, it may also reduce …
Contributors TD was the sole author of this article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.
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