The daily physiotherapy regimen in cystic fibrosis?

Abstract

The aim of this paper is to question the accepted physiotherapy regimen for children with Fibrocystic Disease. Is it the most effective way of keeping the lungs clear of secretions? How much are we imposing added stress on an already stressed family? Is it not possible to design a programme which reduces stress and is socially acceptable? The traditional physiotherapy regimen of breathing exercises, postural drainage and percussion is described. Forced expiratory technique is described as well as various forms of nebulisation. The psychological impact on the family of a chronic, life-threatening disease, is discussed. Compliance with set physiotherapy regimens and the family's (especially the mother's) reaction to them is discussed. The most recent literature on the effectiveness of traditional physiotherapy techniques is reviewed. From this review as well as from personal experience, it is concluded that a rigid physiotherapy regimen is stressful and compliance is frequently poor. Suggestions are made on how to overcome this. It is stressed that this paper deals with the home programme, not with the hospital programme for acute exacerbations of the disease.

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