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Comparison of Flutter device and chest physical therapy in the treatment of cystic fibrosis pulmonary exacerbation.

Abstract

Chest physiotherapy (CPT) is recommended for the clearance of bronchial secretions in the management of patients with cystic fibrosis (CF). The Flutter valve (Scandipharm, Birmingham, AL) has been introduced as an alternative method to CPT for airway mucus clearance. The objective of this study was to compare the short-term effects of CPT and the Flutter valve on pulmonary function and exercise tolerance in patients with cystic fibrosis. Twenty-three patients, 5 to 21 years of age, were randomized to receive one of two interventions: CPT or the Flutter valve, upon admission to the hospital for a 2-week treatment of pulmonary exacerbation. Pulmonary function testing (PFTs) and the 6-min walk test were performed on admission, day 7, and day 14 of hospitalization. Data analysis indicated no significant differences between the two groups on admission. Both groups showed improvement in pulmonary function test results, but the Flutter group had a higher mean forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV(1)) compared to the CPT group after 1 week of intervention. Both groups continued to improve during the 2-week intervention, with no significant difference in FVC or FEV(1) between groups by the end of 2 weeks. Mean forced expiratory flow rate between 25-75% of vital capacity (FEF(25-75)), 6-min walk distance, and resting arterial oxyhemoglobin saturation (SaO(2)) showed little change by day 7, but improved significantly (P< 0.05) by day 14 of hospitalization in both groups, with no significant difference between groups. This study demonstrated that patients using the Flutter device had better pulmonary function after 1 week of therapy and similar improvement in pulmonary function and exercise tolerance compared to CPT after 2 weeks of therapy, suggesting that Flutter valve therapy is an acceptable alternative to standard CPT during in-hospital care of patients with CF.

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  • Authors+Show Affiliations

    ,

    Department of Pulmonology, All Children's Hospital, St. Petersburg, Florida 33701, USA. gondorm@allkids.org

    , , ,

    Source

    Pediatric pulmonology 28:4 1999 Oct pg 255-60

    MeSH

    Adolescent
    Adult
    Analysis of Variance
    Child
    Child, Preschool
    Cystic Fibrosis
    Drainage, Postural
    Exercise Tolerance
    Female
    Forced Expiratory Volume
    Humans
    Male
    Physical Therapy Modalities
    Recurrence
    Respiratory Therapy
    Sensitivity and Specificity
    Treatment Outcome
    Vibration

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    10497374

    Citation

    Gondor, M, et al. "Comparison of Flutter Device and Chest Physical Therapy in the Treatment of Cystic Fibrosis Pulmonary Exacerbation." Pediatric Pulmonology, vol. 28, no. 4, 1999, pp. 255-60.
    Gondor M, Nixon PA, Mutich R, et al. Comparison of Flutter device and chest physical therapy in the treatment of cystic fibrosis pulmonary exacerbation. Pediatr Pulmonol. 1999;28(4):255-60.
    Gondor, M., Nixon, P. A., Mutich, R., Rebovich, P., & Orenstein, D. M. (1999). Comparison of Flutter device and chest physical therapy in the treatment of cystic fibrosis pulmonary exacerbation. Pediatric Pulmonology, 28(4), pp. 255-60.
    Gondor M, et al. Comparison of Flutter Device and Chest Physical Therapy in the Treatment of Cystic Fibrosis Pulmonary Exacerbation. Pediatr Pulmonol. 1999;28(4):255-60. PubMed PMID: 10497374.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Comparison of Flutter device and chest physical therapy in the treatment of cystic fibrosis pulmonary exacerbation. AU - Gondor,M, AU - Nixon,P A, AU - Mutich,R, AU - Rebovich,P, AU - Orenstein,D M, PY - 1999/9/25/pubmed PY - 1999/9/25/medline PY - 1999/9/25/entrez SP - 255 EP - 60 JF - Pediatric pulmonology JO - Pediatr. Pulmonol. VL - 28 IS - 4 N2 - Chest physiotherapy (CPT) is recommended for the clearance of bronchial secretions in the management of patients with cystic fibrosis (CF). The Flutter valve (Scandipharm, Birmingham, AL) has been introduced as an alternative method to CPT for airway mucus clearance. The objective of this study was to compare the short-term effects of CPT and the Flutter valve on pulmonary function and exercise tolerance in patients with cystic fibrosis. Twenty-three patients, 5 to 21 years of age, were randomized to receive one of two interventions: CPT or the Flutter valve, upon admission to the hospital for a 2-week treatment of pulmonary exacerbation. Pulmonary function testing (PFTs) and the 6-min walk test were performed on admission, day 7, and day 14 of hospitalization. Data analysis indicated no significant differences between the two groups on admission. Both groups showed improvement in pulmonary function test results, but the Flutter group had a higher mean forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV(1)) compared to the CPT group after 1 week of intervention. Both groups continued to improve during the 2-week intervention, with no significant difference in FVC or FEV(1) between groups by the end of 2 weeks. Mean forced expiratory flow rate between 25-75% of vital capacity (FEF(25-75)), 6-min walk distance, and resting arterial oxyhemoglobin saturation (SaO(2)) showed little change by day 7, but improved significantly (P< 0.05) by day 14 of hospitalization in both groups, with no significant difference between groups. This study demonstrated that patients using the Flutter device had better pulmonary function after 1 week of therapy and similar improvement in pulmonary function and exercise tolerance compared to CPT after 2 weeks of therapy, suggesting that Flutter valve therapy is an acceptable alternative to standard CPT during in-hospital care of patients with CF. SN - 8755-6863 UR - https://www.unboundmedicine.com/medline/citation/10497374/Comparison_of_Flutter_device_and_chest_physical_therapy_in_the_treatment_of_cystic_fibrosis_pulmonary_exacerbation_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=8755-6863&amp;date=1999&amp;volume=28&amp;issue=4&amp;spage=255 DB - PRIME DP - Unbound Medicine ER -