Oscillating devices for airway clearance in people with cystic fibrosis

Cochrane Database of Systematic Reviews

Volumn , Issue 1, 2009, Pages

  Morrison, Lisa ^a   Agnew, Jennifer ^b  

^a GARTNAVEL GENERAL HOSPITAL   (United Kingdom)

^b HOSPITAL FOR SICK CHILDREN   (Canada)

Author keywords

Adolescent; Adult; Breathing exercises; Child; Cystic fibrosis *complications; physiopathology ; Forced expiratory volume; Humans; Lung diseases, obstructive etiology; *therapy ; Mucus *secretion ; Physical therapy modalities *instrumentation ; Randomized controlled trials as topic

Indexed keywords

CLINICAL TRIAL; COCHRANE LIBRARY; CONTROLLED STUDY; CYSTIC FIBROSIS; DATA BASE; DEVICE THERAPY; FORCED EXPIRATORY VOLUME; HUMAN; INTERMETHOD COMPARISON; LUNG CLEARANCE; LUNG FUNCTION TEST; META ANALYSIS; OSCILLATION; OUTCOME ASSESSMENT; PATIENT SATISFACTION; PHYSIOTHERAPY; RESIDUAL VOLUME; REVIEW; SPUTUM; SYSTEMATIC REVIEW; THORAX WALL; TREATMENT OUTCOME; VENTILATOR;

EID: 70049099600     PISSN: 1469493X     EISSN: None     Source Type: Journal    
DOI: 10.1002/14651858.CD006842.pub2     Document Type: Review

References (111)

1. App EM, Danzl G, Schweiger K, Kieselmann R, Reinhardt D, Lindemann H, et al.Sputum rheology changes in cystic fibrosis lung disease following two different types of physiotherapy - VRP1 (flutter) versus autogenic drainage [abstract]. American Journal of Respiratory and Critical Care Medicine. 1995; Vol.151, issue 4 Suppl: A737.
2. App EM, Kieselmann R, Reinhardt D, LindemannH, Dasgupta B, KingM, et al.Sputum rheology changes in cystic fibrosis lung disease following two different types of physiotherapy: flutter vs autogenic drainage. Chest 1998;114(1):171-177
3. Arens R, Gozal D, Omlin KJ, Vega J, Boyd KP, Keens TG, et al.Comparison of high frequency chest compression and conventional chest physiotherapy in hospitalized patients with cystic fibrosis. American Journal of Respiratory and Critical CareMedicine 1994; 150(4):1154-1157
4. Arens R, Gozal D, Omlin KJ, Vega J, Boyd KP, Woo MS, et al.Comparative efficacy of high frequency chest compression and conventional chest physiotherapy in hospitalized patients with cystic fibrosis [abstract]. Pediatric Pulmonology. 1993; Vol.Suppl 9:239.
5. BraggionC,Cappelletti LM,CornacchiaM, Zanolla L,MastellaG. Short-term effects of three chest physiotherapy regimens in patients hospitalized for pulmonary exacerbations of cystic fibrosis: a crossover randomized study. Pediatric Pulmonology 1995;19(1):16-22.
6. Cappelletti LM, Cornacchia M, Braggion C, Zanolla L, Mastella G. Short-term effects of 3 physiotherapy (CPT) regimens in cystic fibrosis (CF) patients hospitalized for a pulmonary exacerbation: a crossover randomized trial [abstract]. In: Proceedings of 18th European Cystic Fibrosis Conference; 1993 May 21-26; Madrid, Spain. 1993: W9.3.
7. Darbee JC, Kanga JF, Ohtake PJ. Physiologic Eeidence for high-frequency chest wall oscillation and positive expiratory pressure breathing in hospitalized subjects with cystic fibrosis. Physical Therapy 2005;85(12):1278-1289
8. Darbee JC, Kanga JF, Ohtake PJ. Physiologic evidence for high frequency chest wall oscillation and positive expiratory pressure breathing in hospitalized patients with cystic fibrosis [abstract]. Pediatric Pulmonology 2005;40(Suppl 28):322.
9. Giles D, Sontag M, Wagener J, Accurso F. Effect of one month of treatment with flutter valve or postural drainage and clapping on pulmonary function and sputumrecovery in cystic fibrosis [abstract]. Pediatric Pulmonology. 1996; Vol.Suppl 13:307.
10. Gondor M, Nixon PA, Mutich R, Rebovich P, Orenstein DM. Comparison of flutter device and chest physical therapy in the treatment of cystic fibrosis pulmonary exacerbation. Pediatric Pulmonology 1999;28(4):255-260
11. Gondor M, Nixon PA, Rebovich PJ, Orenstein DM. A comparison of the flutter device and chest physical therapy in the treatment of cystic fibrosis pulmonary exacerbation [abstract]. Pediatric Pulmonology. 1996; Vol.Suppl 13:307.
12. Gotz M,Wolkerstorfer A. Physiotherapy in cystic fibrosis: Intrapulmonary percussive ventilation (IPV) versus positive expiratory pressure (PEP) [abstract]. Pediatric Pulmonology 1995;20(Suppl 12):267.
13. Hansen LG, Warwick WJ. High-frequency chest compression system to aid in clearance of mucus from the lung. Biomedical Instrumentation & Technology 1990;24(4):289-294
14. Hare KL, Homnick DN, Cucos D, Marks JH. The PercussiveTech HF device compared to standard chest physiotherapy in hospitalized patients with cystic fibrosis [abstract]. Pediatric Pulmonology 2002; Suppl 24:316.
15. Homnick D, Spillers C, White F. The intrapulmonary percussive ventilator compared to standard aerosol therapy and chest physiotherapy in the treatment of patients with cystic fibrosis [abstract]. Pediatric Pulmonology 1994;Suppl 10:266.
16. Homnick DN, White F, de Castro C. Comparison of effects of an intrapulmonary percussive ventilator to standard aerosol and chest physiotherapy in treatment of cystic fibrosis. Pediatric Pulmonology 1995;20:50-55 [MEDLINE: 1999007053]
17. Homnick DN, Anderson K, Marks JH. Comparison of the flutter device to standard chest physiotherapy in hospitalized patients with cystic fibrosis: a pilot study. Chest 1998;114(4):993-997 [MEDLINE: 1999007053]
18. Homnick DN, Marks JH. Comparison of the flutter device to standard chest physiotherapy in hospitalized patients with cystic fibrosis [abstract]. Pediatric Pulmonology 1996;Suppl 13:308.
19. Kluft J, Beker L, Castagnino M, Gaiser J, Chaney H, Fink RJ. A comparison of bronchial drainage treatments in cystic fibrosis. Pediatric Pulmonology 1996;22(4):271-274 [MEDLINE: 97061859] (Pubitemid 26363862)
20. Lyons E, Chatham K, Campbell IA, Prescott RJ. Evaluation of the flutter VRP1 device in young adults with cystic fibrosis [abstract]. 11th International Cystic Fibrosis Congress; 1992; Dublin, Ireland. 1992:AHP30.
21. Marks JH,Hare K,HomnickDN. The PercussiveTechHF compared to the flutter in cystic fibrosis patients: a six month pilot study [abstract]. Proceedings of 24th European Cystic Fibrosis Conference; 2001 June 6-9; Vienna, Austria. 2001:P101.
22. Marks JH, Homnick DN, Hare K, Cucos D. The PercussiveTech HF compared to the flutter device in cystic fibrosis patients: a six month pilot study [abstract]. Pediatric Pulmonology 2001;32(Suppl 22):309.
23. Davidson AGF, McIlwaine PM, Wong LTK, Peacock D. "Flutter versus PEP": A long-term comparative trial of positive expiratory pressure (PEP) versus oscillating positive expiratory pressure (Flutter) physiotherapy techniques [abstract]. In: Proceedings of 22nd European Cystic FibrosisConference; 1998 June 13-19; Berlin, Germany. 1998:71.
24. McIlwaine PM, Wong LT, Peacock D, Davidson AG. Long-term comparative trial of positive expiratory pressure versus oscillating positive expiratory pressure (flutter) physiotherapy in the treatment of cystic fibrosis. Journal of Pediatrics 2001;138(6):845-850
25. McIlwaine PM,Wong LTK, Peacock D, Davidson AGF. "Flutter versus PEP": A long-term comparative trial of positive expiratory pressure (PEP) versus oscillating positive expiratory pressure (FLUTTER) physiotherapy [abstract]. Pediatric Pulmonology 1997;23(Suppl 14): 299.
26. Milne SM, Eales CJ. A pilot study comparing two physiotherapy techniques in patients with cystic fibrosis. South African Journal of Physiotherapy 2004;60(2):3-6.
27. Accurso FJ, Sontag MK, Koenig JM, Quittner AL.Multi-center airway secretion clearance study in cystic fibrosis [abstract]. Pediatric Pulmonology 2004;38(Suppl 27):314.
28. Modi AC, SontagMK, Koenig JM, Accurso FJ, Quittner AL, Investigators and Coordinators of the Airway Secretion Clearance Study. Adherence to airway clearance therapies in patients with cystic fibrosis [abstract]. Journal of Cystic Fibrosis 2006;5 Suppl:S97.
29. Quittner AL, Modi AC, Accurso FJ, Koenig JM, Sontag MK, Oermann C, et al.Treatment satisfaction, health-related quality of life and airway clearance therapies in patients with cystic fibrosis [abstract]. Pediatric Pulmonology 2004;38(Suppl 27):314.
30. Accurso FJ, Sontag MK, Koenig JM, Quittner AL.Multi-center airway secretion clearance study in cystic fibrosis [abstract]. Pediatric Pulmonology 2004;38(Suppl 27):314.
31. Modi AC, SontagMK, Koenig JM, Accurso FJ, Quittner AL, Investigators and Coordinators of the Airway Secretion Clearance Study. Adherence to airway clearance therapies in patients with cystic fibrosis [abstract]. Journal of Cystic Fibrosis 2006;5 Suppl:S97.
32. Quittner AL, Modi AC, Accurso FJ, Koenig JM, Sontag MK, Oermann C, et al.Treatment satisfaction, health-related quality of life and airway clearance therapies in patients with cystic fibrosis [abstract]. Pediatric Pulmonology 2004;38(Suppl 27):314.
33. Newbold ME, Brooks D, Tullis DE, Ross BG. Effectiveness of the flutter device versus the PEP mask in the treatment of adult cystic fibrosis [abstract]. Pediatric Pulmonology 2000;30(Suppl 20):304.
34. Newbold ME, Tullis E, Corey, M, Ross B, Brooks D. The Fluter Device versus the PEP Mask in the Treatment of Adults with Cystic Fibrosis. Physiotherapy Canada 2005;57(3):199-207.
35. Oermann CM, Sockrider MM, Giles D, Sontag MK, Accurso FJ, Castile RG. Comparison of high-frequency chest wall oscillation and oscillating positive expiratory pressure in the home management of cystic fibrosis: a pilot study. Pediatric Pulmonology 2001;32(5):372-377 (Pubitemid 33015654)
36. Osman.L.P, Roughton. M, Hodson. M.E, Pryor.J.A. High frequency chest wall oscillation in cystic fibrosis. Journal of cystic fi- brosis. 2008; Vol.7, issue Suppl 2:295.
37. Padman R, Geouque DM, Engelhardt MT. Effects of the flutter device on pulmonary function studies among pediatric cystic fibrosis patients. Delaware Medical Journal 1999;71(1):13-18
38. Padman R, Geouque DM, Engelhardt MT. Effects of the flutter device on pulmonary function studies among pediatric cystic fibrosis patients. Delaware Medical Journal 1999;71(1):13-18
39. PhillipsGE, Pike S, Jaffe A, Bush A.Comparison of the active cycle of breathing techniques and external high frequency oscillation jacket for clearance of secretions in children with cystic fibrosis [abstract]. Thorax 1998;53(Suppl 4):A61. (Pubitemid 128777503)
40. Phillips GE, Pike SE, Jaffe A, Bush A. Comparison of active cycle of breathing and high-frequency oscillation jacket in children with cystic fibrosis. Pediatric Pulmonology 2004;37(1):71-75
41. Pike SE,Machin AC,Dix KJ, Pryor JA,HodsonME. Comparison of flutterVRPI and forced expirations (FE) with active cycle of breathing techniques (ACBT) in subjects with cystic fibrosis (CF) [abstract]. The Netherlands Journal of Medicine 1999;54(Suppl):S55-6.
42. Main E, TannenbaumE, Stanojevic S, Scrase E, Prasad A. The effects of positive expiratory pressure (PEP) or oscillatory positive pressure (RC Cornet® ) on FEV1 and lung clearance index over a twelve month period in children with CF [abstract]. Pediatric Pulmonology 2006;41(Suppl 29):351.
43. Prasad A, Tannenbaum E, Bryon M, Main E. One year trial of two airway clearance techniques in children with cystic fibrosis: limitations of the quality of well-being scale [abstract]. Pediatric Pulmonology 2005;40(Suppl 28):323.
44. Tannenbaum E, Prasad SA, Main E, Scrase E. Long term effects of positive expiratory pressure (PEP) or oscillatory positive pressure (RC Cornet® ) on FEV1 and perceived health in children with CF [abstract]. Proceedings of 28thEuropeanCystic FibrosisConference; 2005 June 22-25; Crete, Greece. 2005:S100.
45. Pryor JA,Webber BA,HodsonME,Warner JO. The Flutter VRP1 as an adjunct to chest physiotherapy in cystic fibrosis. Respiratory Medicine 1994;88(9):677-681
46. Pryor JA, Webber BA, Hodson ME, Warner JO. The Flutter VRP1 as an adjunct to chest physiotherapy in cystic fibrosis [abstract]. 11th InternationalCystic FibrosisCongress; 1992; Dublin, Ireland. 1992: WP 102.
47. Pryor JA, Tannenbaum E, Cramer D, Scott SF, Burgess J, Gyi K, et al.A comparison of five airway clearance techniques in the treatment of people with Cystic Fibrosis [abstract]. Journal of Cystic Fibrosis 2006;5(Suppl):S76.
48. vanWinden CMQ, Visser A,HopW, Sterk PJ, Beckers S, de Jongste JC. Effects of Flutter and PEP-MASK on expectoration and lung function in cystic fibrosis [abstract]. Israel Journal of Medical Sciences. 1996; Vol.32, issue Suppl:S275.
49. van Winden CMQ, Visser A, Hop W, Sterk PJ, Beckers S, de Jongste JC. Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis. European Respiratory Journal 1998;12(1):143-147
50. Castile R, Tice J, Flucke R, Filbrun D, Varekojis S,McCoy K. Comparison of three sputum clearance methods in in-patients with cystic fibrosis [abstract]. Pediatric Pulmonology. 1998; Vol.26, issue Suppl 17:329. [MEDLINE: 97221261]
51. Varekojis SM,Douce FH, Flucke RL, Filbrun DA, Tice JS,McCoy KS, et al.A comparison of the therapeutic effectiveness of and preference for postural drainage and percussion, intrapulmonary percussive ventilation, and high-frequency chest wall compression in hospitalized cystic fibrosis patients. Respiratory Care 2003;48(1):24-28
52. Castile R, Tice J, Flucke R, Filbrun D, Varekojis S,McCoy K. Comparison of three sputum clearance methods in in-patients with cystic fibrosis [abstract]. Pediatric Pulmonology. 1998; Vol.26, issue Suppl 17:329. [MEDLINE: 97221261]
53. Varekojis SM,Douce FH, Flucke RL, Filbrun DA, Tice JS,McCoy KS, et al.A comparison of the therapeutic effectiveness of and preference for postural drainage and percussion, intrapulmonary percussive ventilation, and high-frequency chest wall compression in hospitalized cystic fibrosis patients. Respiratory Care 2003;48(1):24-28
54. Warwick WJ, Wielnski CI. Matched pair comparison of manual chest physical therapy (CPT) and the thairapy bronchial drainage vest (ThBVD) system [abstract]. Pediatric Pulmonology. 1990; Vol.Suppl 5:177.
55. Warwick WJ, Wielinski CL, Hansen LG. Comparison of expectorated sputumaftermanual chest physical therapy and high-frequency chest compression. Biomedical Instrumentation Technology 2004;38 (6):470-475
56. Cantin AM, Berthiaume Y. Clearance of airway secretions with the Frequencer in patients with cystic fibrosis [abstract]. Pediatric Pulmonology. 2004; Vol.38, issue Suppl 27:322.
57. Cegla UH, Retzow A. Physical therapy with VRP1 in chronic obstructive respiratory tract diseases - results of a multicenter comparative study [Physiotherapie mit dem VRP1 bei chronisch obstruktiven Atemwegserkrankungen - Ergebnisse einer multizentrischen Vergleichsstudie]. Pneumologie 1993;47(11):636-639
58. ElkinsMR, Eberl S,Alison J, Bye P. The effect of bi-level non-invasive ventilation on mucociliary clearance in subjects with cystic fibrosis [abstract]. Pediatric Pulmonology 2004;38(Suppl 27):315.
59. Elkins MR, Eberl S, Constable C, White J, Robinson M, Daviskas E, et al.The effect of manual chest physiotherapy, positive expiratory pressure (PEP), and oscillating PEP on mucociliary clearance in subjects with cystic fibrosis [abstract]. Pediatric Pulmonology 2005;40 (Suppl 28):321.
60. Hartsell M, Traver G, Taussig LM. Comparison of manual percussion and vibration (P &V) vs. mechanical vibration (MV) alone on maximal expiratory flows [abstract]. 19th Cystic Fibrosis Club Abstracts; 1978:49.
61. KonstanMW, Stern RC, Doershuk CF. Efficacy of the Flutter device for airway mucus clearance in patients with cystic fibrosis. Journal of Pediatrics 1994;124(5 (Pt 1)):689-693
62. Kraig R, Kirkpatrick KR, Howard D, Ter-Pogossian M, Kollef MH. A direct comparison ofmanual chest percussion with acoustic percussion, an experimental treatment for cystic fibrosis [abstract]. American Journal of Respiratory and Critical Care Medicine 1995;151(4 Suppl):A738.
63. Lagerkvist AL, Sten G, Lindblad A, Redfors S. Chest physiotherapy with positive expiratory pressure (PEP) and oscillating positive expiratory pressure (flutter) in patients with cystic fibrosis-a comparative study [abstract]. Proceedings of 21st European Cystic Fibrosis Conference; 1997 June 1-6; Davos, Switzerland. 1997:132.
64. Lagerkvist AL, StenGM, Redfors SB, Lindblad AG,Hjalmarson O. Immediate changes in blood-gas tensions during chest physiotherapy with positive expiratory pressure and oscillating positive expiratory pressure in patients with cystic fibrosis. Respiratory Care 2006;51 (10):1154-1161
65. Lindemann H. The value of physical therapy with VRP 1-Desitin ("Flutter") [Zum Stellenwert der Physiotherapie mit dem VRP 1-Desitin ("Flutter")]. Pneumologie 1992;46(12):626-630
66. Majaesic CM, Montgomery M, Jones R, King M. Reduction in sputumviscosity using high frequency chest compressions (HFCC) compared to conventional chest physiotherapy (CCP) [abstract]. Pediatric Pulmonology 1996;Suppl 13:308.
67. Marks JH, Fooy C, Anderson K,Homnick DN. Nebulized albuterol delivered with positive expiratory pressure (PEP) and the flutter device in patients with cystic fibrosis: an assessment of bronchodilator response compared to standard nebulizer therapy [abstract]. American Journal of Respiratory and Critical Care Medicine. 1998; Vol.157, issue 3 Suppl:A130.
68. Marks, J.H, Hare, K.L, Homnick, D.N. Pulmonary Function and Sputum Production in Patients with cystic fibrosis: A pilot study comparing the Percussivetech HF device and standard chest physiotherapy. Pediatric pulmonology. 1999; Vol.Suppl 19:290.
69. Marks J, Hare K, Homnick D. The PercussiveTech HF device compared to standard chest physiotherapy in patients with cystic fibrosis [abstract]. Proceedings of 13th International Cystic Fibrosis Congress; 2000 June 4-8; Stockholm, Sweden. 2000:151.
70. Marks JH, Hare KL, Homnick DN. Pulmonary function and sputum production in patients with cystic fibrosis: a pilot study comparing the percussive tech HF device and standard chest physiotherapy [abstract]. Pediatric Pulmonology 1999;28(Suppl 19):290.
71. Marks JH, Hare KL, Saunders RA, Homnick DN. Pulmonary function and sputum production in patients with cystic fibrosis: a pilot study comparing the PercussiveTech HF device and standard chest physiotherapy. Chest 2004;125(4):1507-1511
72. McCarren B, Alison JA. Comparison of vibration to other physiotherapy interventions for secretion clearance [abstract]. European Respiratory Journal 2005;26(Suppl 49):497s.
73. McCarren B, Alison JA. Physiological effects of vibration in subjects with cystic fibrosis. European Respiratory Journal 2006;27(6):1204-1209
74. Morris D, BarberoG, Konig P,WoodruffC, Kline J,Martinez R. The effect of mechanical and manual percussion on pulmonary function in cystic fibrosis patients [abstract]. 23rd Annual Meeting Cystic Fibrosis Club Abstracts; 1982May 14;Washington D.C. 1982:135.
75. Natale JE, Pfeifle J, Homnick DN. Comparison of intrapulmonary percussive ventilation and chest physiotherapy. A pilot study in patients with cystic fibrosis. Chest 1994;105(6):1789-1793 (Pubitemid 24180670)
76. Newhouse P, White F, Marks J, Homnick D. Pulmonary function testing and sputum production in patients with cystic fibrosis: A pilot study comparing the flutter device, intrapulmonary percussive ventilator, and standard chest physiotherapy [abstract]. Pediatric Pulmonology 1995;Suppl 12:269.
77. Newhouse PA, White F, Marks JH, Homnick DN. The intrapulmonary percussive ventilator and flutter device compared to standard chest physiotherapy in patients with cystic fibrosis. Clinical Pediatrics 1998;37(7):427-432 (Pubitemid 28340384)
78. Roos S, Birrer P, Rüdeberg A, Kraemer R. First experience with intrapulmonary percussive ventilation (IPV) in the treatment of patients with cystic fibrosis [abstract]. Proceedings of 15th Annual Meeting of the European Working Group for Cystic Fibrosis; 1987; Oslo, Norway. 1987.
79. SalhW, Bilton D, DoddM,Webb AK. Effect of exercise and physiotherapy in aiding sputum expectoration in adults with cystic fibrosis. Thorax 1989;44(12):1006-1008
80. Scherer TA, Barandun J, Martinez E, Wanner A, Rubin EM. Effect of high-frequency oral airway and chest wall oscillation and conventional chest physical therapy on expectoration in patients with stable cystic fibrosis. Chest 1998;113(4):1019-1027 [MEDLINE: 98213362] (Pubitemid 28216448)
81. Skopnik H, Waters W, Horowitz AE, Roth B, Benz-Bohm G. Evaluation of Knock and Vibrattion Therapy and Autogenic drainage in Cystic Fibrosis Using a Ventilation Zintigraphical method [Beurteilung der Klopf und Vibrationstherapie und autogenic drainage bei cystischer fibrose mittels eines ventilationsszintigrafischen Verfahrens]. Monatsscurift fur Kinderheilkunde. 1986; Vol.134:583.
82. Stites SW, Perry GV, Peddicord T, Cox G, McMillan C, Becker B. Effect of high-frequency chest wall oscillation on the central and peripheral distribution of aerosolized diethylene triamine penta-acetic acid as compared to standard chest physiotherapy in cystic fibrosis. Chest 2006;129(3):712-717
83. Webber BA, Parker RA, Hofmeyr JL, Hodson ME. Evaluation of self-percussion during postural drainage using the forced expiration technique (FET) [abstract]. Proceedings of 9th International Cystic Fibrosis Congress; 1984 June 9-15; Brighton, England. 1984:2.12.
84. Orlik T. [Estimation of autodrainage methods in a selected group of cystic fibrosis patients with home environment factors taken into consideration] [Ocena metod autodren azu w wybranej grupie chorych na mukowiscydoze z uwzglednieniem czynnika strodowiskowego]. Medycyna Wieku Rozwojowego 2000;4(3):247-259
85. Orlik T. Evaluation of the efficiency of selected thoracic physiotherapy methods used in the treatment of patients with cystic fibrosis [Ocena efektywnosci wybranych metod fizjoterapii klatki piersiowej stosowanej w leczeniu chorych namukowiscydoze]. Medycyna Wieku Rozwojowego 2000;4(3):233-246
86. Orlik T, Sands D. Long-termevaluation of effectiveness for selected chest physiotherapy methods used in the treatment of cystic fibrosis [Dlugofalowa ocena skutecznosci wybranych metod fizjoterapii klatki piersiowej stoswanych w leczeniu chorych na mukowiscydoze]. Medycyna Wieku Rozwojowego 2001;5(3):245-257
87. Orlik T, Sands D. Long-term study of efficiencies of select physiotherapy methods used in the treatment of cystic fibrosis [abstract]. Proceedings of 24th EuropeanCystic FibrosisConference; 2001 June 6-9; Vienna, Austria. 2001:P113.
88. Bradley J, Moran F. Physical training for cystic fibrosis. Cochrane Database of Systematic Reviews 2002, Issue 2. [DOI: 10.1002/14651858.CD002768. pub2]
89. Cantin A. Cystic fibrosis lung inflammation: early, sustained, and severe. American Journal of Respiratory and Critical Care Medicine 1995;151(4):939-941
90. Chevaillier J. Autogenic drainage. In: Lawson D editor(s). Cystic Fibrosis: Horizons. London: Churchill Livingstone, 1984:65-78.
91. Curtin F, Altman DG, Elbourne E.Meta-analysis combining parallel and cross-over clinical trials. I:Continuous outcomes.. STATISTICS IN MEDICINE 2002;21:2131-2144. (Pubitemid 34830752)
92. Curtin F, Altman DG, Elbourne E.Meta-analysis combining parallel and cross-over clinical trials. III: The issue of carryover.. STATISTICS IN MEDICINE 2002;21:2161-2173. (Pubitemid 34830754)
93. Elbourne DR, Altman DG, Higgins JPT, Curtin F, Worthington HV,VailA.Meta-analyses involving cross-over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140-149 (Pubitemid 34284916)
94. Elkins MR, Jones A, van der Schans C. Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis. Cochrane Database of Systematic Reviews 2006, Issue 2. [DOI: 10.1002/14651858.CD003147. pub3]
95. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327(7414):557-560
96. Nomnick DN, White F, de Castro C. Comparison of effects of intermittent percussive ventilator to standard aerosol and chest physiotherapy in treatment of cystic fibrosis. Pediatric Pulmonology 1995; 20(1):50-55
97. Jüni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ 2001;323 (7303):42-46 (Pubitemid 32682008)
98. Konstan MW, Berger M. Current understanding of the inflammatory process in cystic fibrosis: onset and etiology. Pediatric Pulomonolgy 1997;24(2):137-142 (Pubitemid 27450731)
99. Main E, Prasad A, van der Schans C. Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis. Cochrane Database of Systematic Reviews 2005, Issue 1. [DOI: 10.1002/14651858.CD002011. pub2]
100. Prasad SA. Current concepts in physiotherapy. Journal of the Royal Society of Medicine 1993;86(Suppl 20):23-29
101. Pryor J. Physiotherapy for airway clearance in adults. European Respiratory Journal 1999;14(6):1418-1424
102. Rogers D, Doull IJM. Physiological principles of airway clearance techniques used in the physiotherapy management of cystic fibrosis. Current Paediatrics 2005;15(3):233-238 (Pubitemid 40693313)
103. Rosenfeld M, Emerson J, Williams-Warren J, Pepe M, Smith A, Montgomery AB, Ramsey B. Defining a pulmonary exacerbation in cystic fibrosis. Journal of Pediatrics 2001;139(3):359-365 (Pubitemid 32889511)
104. SchöniMH. Autogenic drainage: a modern approach to physiotherapy in cystic fibrosis. Journal of Royal Society of Medicine 1989;82 (Suppl 16):32-37
105. Volsko TA, DiFiore JM, Chatburn RL. Performance comparison of two oscillatory positive pressure devices: Acapella versus Flutter. Respiratory Care 2003;48(2):124-130
106. Warwick WJ, Hansen LG. The long-term effect of high frequency chest compression therapy on pulmonary complications of cystic fibrosis. Pediatric Pulmonology 1991;11(3):265-271
107. Webb AK, DoddME,Moorcroft J. Exercise and cystic fibrosis. Journal of the Royal Society of Medicine 1995;88(Suppl 25):30-36
108. Webber BA, Hofmeyer JL, Moran MDL, Hodson ME. Effects of postural drainage, incorporating forced expiration technique, on pulmonary function in cystic fibrosis. British Journal of Diseases of the Chest 1986;80(4):353-359 (Pubitemid 17174000)
109. Webber BA. The active cycle of breathing exercises. Cystic Fibrosis News 1990;Aug/Sept:10-11
110. Williams, EJ. Experimental designs balanced for the estimation of residual effects of treatments. Australian Journal of Scientific Research 1949;Series A, Volume 2:149-168
111. ZachMS. Lung disease in cystic fibrosis - an updated concept. Pediatric Pulmonology 1990;8(3):188-202.