Adherence to chest physiotherapy, airway clearance techniques and physical exercise by children and adolescents with cystic fibrosis
DOI:
https://doi.org/10.36311/jhgd.v34.15779Palabras clave:
physical therapy, cystic fibrosis, Aerobic Exercise, patient compliance, vidence-based practiceResumen
Introduction: chest physiotherapy, airway clearance techniques, and physical exercise are associated with better outcomes in cystic fibrosis, but adherence to these recommendations remains a challenge.
Objective: to assess adherence to chest physiotherapy, airway clearance techniques, and physical exercise by children and adolescents with cystic fibrosis and analyze the factors related to adherence.
Methods: retrospective study of children and adolescents with cystic fibrosis from a pediatric referral center in Brazil. Data were collected from electronic records of the multidisciplinary team responsible for caring for these patients at the referral center.
Results: the sample included all 83 patients registered at the referral center, with a mean age of 7.88 ± 4.88 years. Among them, 28.9% did not have weekly chest physiotherapy, 66.3% did not practice physical exercise regularly, and only 38.6% practiced airway clearance techniques from 6 to 7 times a week. Higher adherence to airway clearance techniques was associated with higher mean age (p<0.01) and correlated with FEV1 (r=-0.39; p=0.03), FEF25-75% (r =-0.36; p=0.02), FEV1/FVC (r =-0.43; p=0.01) and lower mean Shwachman-Kulczycki Score (r=-0.34; p<0.01). Higher physical exercise adherence was associated with a higher mean age (p<0.01). Individuals using public financing of physiotherapy services had a lower Shwachman-Kulczycki Score (p=0.02) than those using non-public services. The metropolitan region had a higher percentage of individuals using non-public services than other regions (p<0.01).
Conclusion: adherence to chest physiotherapy, airway clearance techniques and physical exercise was lower than recommendations. Airway clearance techniques and physical exercise adherence increased with age, and airway clearance techniques adherence was associated with the high severity of disease. These results suggest that patients only increase adherence when they get older and the disease worsens, highlighting the need for strategies to increase adherence early.
Descargas
Referencias
Ong T, Ramsey BW. Cystic Fibrosis: A Review. JAMA [Internet]. 2023 Jun 6;329(21):1859–71. Available from: http://dx.doi.org/10.1001/jama.2023.8120
Turcios NL. Cystic Fibrosis Lung Disease: An Overview. Respir Care [Internet]. 2020 Feb;65(2):233–51. Available from: http://dx.doi.org/10.4187/respcare.06697
Harun SN, Wainwright C, Klein K, Hennig S. A systematic review of studies examining the rate of lung function decline in patients with cystic fibrosis. Paediatr Respir Rev [Internet]. 2016 Sep;20:55–66. Available from: http://dx.doi.org/10.1016/j.prrv.2016.03.002
Kerem E. Cystic fibrosis: Priorities and progress for future therapies. Paediatr Respir Rev [Internet]. 2017 Sep;24:14–6. Available from: http://dx.doi.org/10.1016/j.prrv.2017.06.004
Athanazio RA, Silva Filho LVRF da, Vergara AA, Ribeiro AF, Riedi CA, Procianoy E da FA, et al. Brazilian guidelines for the diagnosis and treatment of cystic fibrosis. J Bras Pneumol [Internet]. 2017 May-Jun;43(3):219–45. Available from: http://dx.doi.org/10.1590/S1806-37562017000000065
Castellani C, Duff AJA, Bell SC, Heijerman HGM, Munck A, Ratjen F, et al. ECFS best practice guidelines: the 2018 revision. J Cyst Fibros [Internet]. 2018 Mar;17(2):153–78. Available from: http://dx.doi.org/10.1016/j.jcf.2018.02.006
Button BM, Wilson C, Dentice R, Cox NS, Middleton A, Tannenbaum E, et al. Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline. Respirology [Internet]. 2016 May;21(4):656–67. Available from: http://dx.doi.org/10.1111/resp.12764
Conway S, Balfour-Lynn IM, De Rijcke K, Drevinek P, Foweraker J, Havermans T, et al. European Cystic Fibrosis Society Standards of Care: Framework for the Cystic Fibrosis Centre. J Cyst Fibros [Internet]. 2014 May;13 Suppl 1:S3–22. Available from: http://dx.doi.org/10.1016/j.jcf.2014.03.009
Warnock L, Gates A. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis. Cochrane Database Syst Rev [Internet]. 2015 Dec 21;2015(12):CD001401. Available from: http://dx.doi.org/10.1002/14651858.CD001401.pub3
Rodrigues JC, Cardieri JJA, Ferreira MHL, Nakaie MA, Almeida MB, da Silva LAV, et al. Provas de função pulmonar em crianças e adolescentes. Jornal de Pneumologia [Internet]. 2002; Available from: https://repositorio.usp.br/item/001407568
Stollar F, Adde FV, Cunha MT, Leone C, Rodrigues JC. Shwachman-Kulczycki score still useful to monitor cystic fibrosis severity. Clinics [Internet]. 2011;66(6):979–83. Available from: http://dx.doi.org/10.1590/s1807-59322011000600010
Callegari-Jacques SM. Bioestatística: Princípios e aplicações [Internet]. Artmed Editora; 2009. 253 p. Available from: https://play.google.com/store/books/details?id=nuaVLSCiAgsC
Tavares KO, Carvalho MD de B, Pelloso SM. Difficulties experienced by the mothers of people with cystic fibrosis. Texto contexto - enferm [Internet]. 2014 [cited 2024 Mar 21];23(2):294–300. Available from: https://www.scielo.br/j/tce/a/WhQjDdRqGF4SjRcczZJPmCp/?lang=en
Narayanan S, Mainz JG, Gala S, Tabori H, Grossoehme D. Adherence to therapies in cystic fibrosis: a targeted literature review. Expert Rev Respir Med [Internet]. 2017 Feb;11(2):129–45. Available from: http://dx.doi.org/10.1080/17476348.2017.1280399
Jones M, Moffatt F, Harvey A, Ryan JM. Interventions for improving adherence to airway clearance treatment and exercise in people with cystic fibrosis. Cochrane Database Syst Rev [Internet]. 2023 Jul 18;7(7):CD013610. Available from: http://dx.doi.org/10.1002/14651858.CD013610.pub2
Hwang R, Elkins MR. Telephysiotherapy. J Physiother [Internet]. 2020 Jul;66(3):143–4. Available from: http://dx.doi.org/10.1016/j.jphys.2020.06.002
Portugal I, Bezerra IMP, Junior AD de A, Daboin BEG, Zucoloto HZ, Alves SAA, et al. MeTA-Edu: a new methodology for enhancing validation of health education technologies applied to COVID-19 prevention in adults with cancer. Journal of Human Growth and Development (Impresso) [Internet]. 2023 [cited 2024 Mar 21];84–94. Available from: https://pesquisa.bvsalud.org/gim/resource/fr/biblio-1436206
Feiten TDS, Flores JS, Farias BL, Rovedder PME, Camargo EG, Dalcin P de TR, et al. Respiratory therapy: a problem among children and adolescents with cystic fibrosis. J Bras Pneumol [Internet]. 2016 Jan-Feb;42(1):29–34. Available from: http://dx.doi.org/10.1590/S1806-37562016000000068
Flores JS, Teixeira F , Rovedder PME, Ziegler B, Dalcin P de TR. Adherence to airway clearance therapies by adult cystic fibrosis patients. Respir Care [Internet]. 2013 Feb;58(2):279–85. Available from: http://dx.doi.org/10.4187/respcare.01389
Dalcin P de TR, Rampon G, Pasin LR, Ramon GM, Abrahão CL de O, Oliveira VZ de. [Adherence to treatment in patients with cystic fibrosis]. J Bras Pneumol [Internet]. 2007 Nov-Dec;33(6):663–70. Available from: http://dx.doi.org/10.1590/s1806-37132007000600009
Arias Llorente RP, Bousoño García C, Díaz Martín JJ. Treatment compliance in children and adults with cystic fibrosis. J Cyst Fibros [Internet]. 2008 Sep;7(5):359–67. Available from: http://dx.doi.org/10.1016/j.jcf.2008.01.003
Freire ID, Abreu E Silva FA de, Araújo MA de. Comparison among pulmonary function test results, the Shwachman-Kulczycki score and the Brasfield score in patients with cystic fibrosis. J Bras Pneumol [Internet]. 2008 May;34(5):280–7. Available from: http://dx.doi.org/10.1590/s1806-37132008000500006
Santuzzi CH, Liberato FMG, Morau SAC, de Oliveira NFF, Nascimento LR. Adherence and barriers to general and respiratory exercises in cystic fibrosis. Pediatr Pulmonol [Internet]. 2020 Oct;55(10):2646–52. Available from: http://dx.doi.org/10.1002/ppul.24912
Calella P, Valerio G, Thomas M, McCabe H, Taylor J, Brodlie M, et al. Association between body composition and pulmonary function in children and young people with cystic fibrosis. Nutrition [Internet]. 2018 Apr;48:73–6. Available from: http://dx.doi.org/10.1016/j.nut.2017.10.026
Tomaszek L, Dębska G, Cepuch G, Kulpa M, Pawlik L, Broniatowska E. Evaluation of quality of life predictors in adolescents and young adults with cystic fibrosis. Heart Lung [Internet]. 2019 Mar-Apr;48(2):159–65. Available from: http://dx.doi.org/10.1016/j.hrtlng.2018.08.003
da Silva LA, Lima ACP, Wittmer VL, Liberato F, Arpini L, Paro FM. Quality of life of children and adolescents with cystic fibrosis : the importance of body image and the impact of nutritional status , age and race / skin color on patients ’ and caregivers ’ perceptions. 2018; Available from: https://agris.fao.org/search/en/providers/122436/records/64747bdd79cbb2c2c1b68ff4
Chrysochoou E-A, Hatziagorou E, Kirvassilis F, Tsanakas J. Telephone monitoring and home visits significantly improved the quality of life, treatment adherence and lung function in children with cystic fibrosis. Acta Paediatr [Internet]. 2017 Nov;106(11):1882. Available from: http://dx.doi.org/10.1111/apa.13996
Costa RD, Ferreira M de F de C, Rocha T de A, Galera MF. Evaluation of newborn screening in the state of Mato Grosso from 2005 to 2019. Rev Paul Pediatr [Internet]. 2023 Aug 25;42:e2022161. Available from: http://dx.doi.org/10.1590/1984-0462/2024/42/2022161
Bonfim IM, Córdova ELM, Garcia CCB, Paro FM. Perfil dos pacientes com fibrose cística atendidos no centro de referência pediátrico do Espírito Santo. Rev Bras Pesqui em Saúde/Braz J Health Res [Internet]. 2019 Jul 3; Available from: https://dialnet.unirioja.es/servlet/articulo?codigo=8538540
Donadio MVF, Campos NE, Vendrusculo FM, Stofella AM, Almeida AC da S, Ziegler B, et al. Respiratory physical therapy techniques recommended for patients with cystic fibrosis treated in specialized centers. Braz J Phys Ther [Internet]. 2020 Nov-Dec;24(6):532–8. Available from: http://dx.doi.org/10.1016/j.bjpt.2019.11.003
Prasad SA, Cerny FJ. Factors that influence adherence to exercise and their effectiveness: application to cystic fibrosis. Pediatr Pulmonol [Internet]. 2002 Jul;34(1):66–72. Available from: http://dx.doi.org/10.1002/ppul.10126
Radtke T, Nevitt SJ, Hebestreit H, Kriemler S. Physical exercise training for cystic fibrosis. Cochrane Database Syst Rev [Internet]. 2017 Nov 1;11(11):CD002768. Available from: http://dx.doi.org/10.1002/14651858.CD002768.pub4
Campos NE, Vendrusculo FM, Pérez-Ruiz M, Donadio MVF. Ventilatory Threshold and Risk of Pulmonary Exacerbations in Cystic Fibrosis. Respir Care [Internet]. 2023 May;68(5):620–7. Available from: http://dx.doi.org/10.4187/respcare.10428
McGarry ME, Williams WA 2nd, McColley SA. The demographics of adverse outcomes in cystic fibrosis. Pediatr Pulmonol [Internet]. 2019 Nov;54 Suppl 3(Suppl 3):S74–83. Available from: http://dx.doi.org/10.1002/ppul.24434
Oates GR, Schechter MS. Socioeconomic determinants of respiratory health in patients with cystic fibrosis: implications for treatment strategies. Expert Rev Respir Med [Internet]. 2022 Jun;16(6):637–50. Available from: http://dx.doi.org/10.1080/17476348.2022.2090928
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2024 Módolo LP, Uliana LB, Liberato FMG, Arpini LSB, Santuzzi CH, Melotti RCNC, Paro FM
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
