Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: an overview of five Cochrane systematic reviews.

BACKGROUND: A range of physical therapies (including airway clearance and physical training) are used in cystic fibrosis (CF). The aim of this paper is to summarise the main findings from Cochrane systematic reviews that have considered the evidence for physical therapies in CF. METHODS: All outcomes reported in relevant Cochrane systematic reviews are summarised. RESULTS: Review 1 provides some evidence from short-term trials of the benefit of airway clearance over no airway clearance in improved mucus transport but no definitive evidence from long-term trials to support the efficacy of airway clearance over no airway clearance; review 2 provides some evidence that conventional chest physiotherapy (CCPT) is at least as effective as other forms of airway clearance, but that patients may have a preference for self-administered treatments over CCPT; review 3 provides some evidence that positive expiratory pressure (PEP) is at least as effective as other forms of airway clearance; review 4 provides some evidence to support the use of non-invasive ventilation during airway clearance in patients with moderate to severe disease who have difficulty clearing sputum; review 5 provides some evidence of the benefits of different types of physical training. CONCLUSION: The Cochrane systematic reviews summarised in this paper provide some evidence to support the inclusion of physical therapies in the care-management plan of CF. They also provide information to steer the direction and focus of future research in this area.