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Djelotvornost fizioterapije prsnog koša za liječenje cistične fibroze

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Referencias

References to studies included in this review

Braggion 1995 {published data only}

Braggion C, Cappelletti LM, Cornacchia M, Zanolla L, Mastella G. Short‐term effects of three chest physiotherapy regimens in patients hospitalized for pulmonary exacerbations of cystic fibrosis: a cross‐over randomized study. Pediatric Pulmonology 1995;19(1):16‐22.
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 cross‐over randomized trial [abstract]. Proceedings of the 18th European Cystic Fibrosis Conference; 1993; Madrid. 1993:W9.3.
Cappelletti LM, Cornacchia M, Braggion C, Zanolla L, Mastella G. Short‐term effects of three chest physiotherapy regimens on patients with cystic fibrosis hospitalized for pulmonary exacerbation: a crossover randomized study. Excerpta Medica International Congress Series 1993;1034:239‐46.

Elkins 2005 {published data only}

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. [CFGD Register: PE158]

Falk 1993 {published data only}

Falk M, Mortensen J, Kelstrup M, Lanng S, Larsen L, Ulrik CS. Short‐term effects of positive expiratory pressure and the forced expiration technique on mucus clearance and lung function in CF [abstract]. Pediatric Pulmonology 1993;16 (Suppl 9):241.
Larsen L, Mortensen J, Falk M, Kelstrup M, Lanng S, Ulrik CS. Radiolabelled mucus clearance in patients with cystic fibrosis is improved by physiotherapy with positive expiratory pressure and the forced expiration techniques [abstract]. Clinical Physiology 1994;14:365.
Mortensen J, Falk M, Kelstrup M, Lanng S, Ulrik CS. Effect of positive expiratory pressure and the forced expiration technique on mucus clearance in patients with cystic fibrosis [abstract]. European Respiratory Journal 1993;6(Suppl 17):490s.

Jarad 2010 {published data only}

Jarad NA, Powell T, Smith CE, Cartwright P, Nedwell J. The efficacy, preference and safety of a novel method of sputum clearance, hydro acoustic therapy, on adult patients with cystic fibrosis [abstract]. Thorax 2006;61(Suppl 2):ii120; P194. [CFGD Register: PE172a]
Jarad NA, Powell T, Smith E. Evaluation of a novel sputum clearance technique‐‐hydro‐acoustic therapy (HAT) in adult patients with cystic fibrosis: a feasibility study. Chronic Respiratory Diseases 2010;7(4):217‐27. [CFGD Register: PE172b]

Mortensen 1991 {published data only}

Falk M, Mortensen J, Jensen C, Groth S, Jensen T. Postural drainage or PEP effects on tracheobronchial clearance in cystic fibrosis [abstract]. Pediatric Pulmonology 1990;9 (Suppl 5):226.
Mortensen J, Falk M, Groth S, Jensen C. The effects of postural drainage and positive expiratory pressure physiotherapy on tracheobronchial clearance in cystic fibrosis. Chest 1991;100(5):1350‐7.
Mortensen J, Groth S, Falk M, Jensen C, Jensen T. Assessment of tracheobronchial clearance by sputum expectorated during chest physiotherapy in cystic fibrosis [abstract]. European Respiratory Journal 1990;3(Suppl 10):260s‐61s.

Pfleger 1992 {published data only}

Pfleger A, Theißl B, Oberwaldner B, Zach MS. Self‐administered chest physiotherapy in cystic fibrosis: a comparative study of high‐pressure PEP and autogenic drainage. Lung 1992;170(6):323‐30.
Theißl B, Pfleger A, Oberwaldner B, Zach M. Chest physiotherapy (PT) in Cystic Fibrosis (CF) ‐ a comparative study of high‐pressure PEP and autogenic drainage [abstract]. Pediatric Pulmonology 1990;9 (Suppl 5):259.

Rossman 1982 {published data only}

Rossman C, Waldes R, Sampson D, Newhouse M. Does chest physiotherapy improve mucus removal in patients with cystic fibrosis? [abstract]. Proceedings of the Eighth International Cystic Fibrosis Congress; 1980. 1980:32a.
Rossman CM, Waldes R, Sampson D, Newhouse MT. Effect of chest physiotherapy on the removal of mucus in patients with cystic fibrosis. American Review ff Respiratory Disease 1982;126(1):131‐5.

van der Schans 1991 {published data only}

van der Schans CP, van der Mark TW, de Vries G, Piers DA, Beekhuis H, Dankert‐Roelse JE, et al. Effect of positive expiratory pressure breathing in patients with cystic fibrosis. Thorax 1991;46(4):252‐6.

References to studies excluded from this review

App 1998 {published data only}

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]. Proceedings of the American Thoracic Society (American Journal of Respiratory and Critical Care Medicine Supplements); 1995. 1995; Vol. 151:A737.
App EM, Kieselmann R, Reinhardt D, Lindemann H, Dasgupta B, King M, et al. Sputum rheology changes in cystic fibrosis lung disease following two different types of physiotherapy: flutter vs autogenic drainage. Chest 1998;114(1):171‐7.

Aquino 2012 {published data only}

Aquino ES, Shimura F, Santos AS, Goto DM, Coelho CC, de Fuccio MB, et al. CPAP has no effect on clearance, sputum properties, or expectorated volume in cystic fibrosis. Respiratory Care 2012;57(11):1914‐9. [CENTRAL: 872489; CFGD Register: PE199; CRS: 5500100000011035; JID:: 7510357; PUBMED: 22417659]

Arens 1994 {published data only}

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 Care Medicine 1994;150(4):1154‐7.
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]. Pedaitric Pulmonology 1993;16 (Suppl 9):239.

Bain 1988 {published data only}

Bain J, Bishop J, Olinsky A. Evaluation of directed coughing in cystic fibrosis. British Journal of Diseases of the Chest 1988;82(2):138‐48.

Baldwin 1994 {published data only}

Baldwin DR, Hill AL, Peckham DG, Knox AJ. Effect of addition of exercise to chest physiotherapy on sputum expectoration and lung function in adults with cystic fibrosis. Respiratory Medicine 1994;88(1):49‐53.

Balestri 2004 {published data only}

Balestri E, Ambroni M, Dall' Ara S, Miano A. Efficacy of physical exercise for mucus clearance in patients with cystic fibrosis (CF) [abstract]. Pediatric Pulmonology 2004;38(Suppl 27):316. [CENTRAL: 507888; CFGD Register: PE150; CRS: 5500100000002687]

Baran 1977 {published data only}

Baran D, Penalosa A, Degre S. Physical working capacity before and after chest physiotherapy in cystic fibrosis. Cystic Fibrosis 1977:239‐44.

Battistini 2001 {published data only}

Battistine R, Balestri E, Ambroni M, Miano A. Efficacy of underwater positive expiratory pressure therapy (UPEP) for mucus clearance in patients with cystic fibrosis [abstract]. Abstracts of the 24th European Cystic Fibrosis Conference; 2001 June 6‐9; Vienna. 2001:104.

Bauer 1994 {published data only}

Bauer M, Schoumacher R. Comparison of efficacy of manual and mechanical percussion in cystic fibrosis [abstract]. Pediatric Pulmonology 1990;9 (Suppl 5):249.
Bauer ML, McDougal J, Schoumacher RA. Comparison of manual and mechanical chest percussion in hospitalized patients with cystic fibrosis. Journal of Pediatrics 1994;124(2):250‐4.

Bilton 1992 {published data only}

Bilton D, Dodd M, Webb AK. The benefits of exercise combined with physiotherapy in cystic fibrosis [abstract]. Pediatric Pulmonology 1990;Suppl 5:238.
Bilton D, Dodd ME, Abbot JV, Webb AK. The benefits of exercise combined with physiotherapy in the treatment of adults with cystic fibrosis. Respiratory Medicine 1992;86(6):507‐11.

Blomquist 1986 {published data only}

Blomquist M, FreyschussU, WimanL.G, Strandvik B. Physical activity and self treatment in cystic fibrosis. Archives of Disease in Childhood 1989;61(4):361‐7.

Borka 2012 {published data only}

Borka P, Gyurkovits K, Bodis J. Comparative study of PEP mask and flutter on expectoration in cystic fibrosis patients. Acta Physiologica Hungarica 2012;99(3):324‐31. [CFGD Register: PE198]

Braggion 1996 {published data only}

Braggion C, Pradal U, Mastella G, Coates AL, Milic Emili J. Effect of different inspiratory maneuvers on FEV1 in patients with cystic fibrosis. Chest 1996;110(3):642‐7.

Button 1997 {published data only}

Button BM, Catto‐Smith AG, Olinsky A, Phelan PD, Story I. Newborn screening in cystic fibrosis: the physiotherapist's dilemma in safe and effective treatment ‐ to tip or not to tip? [abstract]. American Journal of Respiratory and Critical Care Medicine 1998;157(Suppl 3):A130. [CFGD Register: PE88e]
Button BM, Heine R, Catto‐Smith A, Olinsky A, Phelan PD, Story I. A twelve month comparison of standard versus modified chest physiotherapy in twenty infants with cystic fibrosis [abstract]. Pediatric Pulmonology 1997;Suppl 14:299. [CFGD Register: PE88a]
Button BM, Heine RG, Catto Smith AG, Phelan PD, Olinsky A. Postural drainage and gastro‐oesophageal reflux in infants with cystic fibrosis. Archives of Disease in Childhood 1997;76(2):148‐50. [CFGD Register: PE88i]
Button BM, Heine RG, Catto‐Smith A, Olinsky A, Phelan PD, Story I. Chest physiotherapy for children with CF‐birth to two years: issues to consider [abstract]. The Netherlands Journal of Medicine 1999;54(Suppl):S18‐S19. [CFGD Register: PE88b]
Button BM, Heine RG, Catto‐Smith AG, Olinsky A, Phelan PD, Ditchfield M, et al. The five year follow‐up of two groups of newly diagnosed infants with CF randomized to receive standard (with tip) of modified (without tip) physiotherapy during infancy [abstract]. Abstracts of the 24th European Cystic Fibrosis Conference; 2001 June 6‐9; Vienna. 2001:111. [CFGD Register: PE88d]
Button BM, Heine RG, Catto‐Smith AG, Olinsky A, Phelan PD, Ditchfield MR, et al. Chest physiotherapy in infants with cystic fibrosis: to tip or not? A five‐year study. Pediatric Pulmonology 2003;35(3):208‐13. [CFGD Register: PE88f]
Button BM, Heine RG, Catto‐Smith AG, Phelan PD. Postural drainage in cystic fibrosis: is there a link with gastro‐oesophageal reflux?. Journal of Paediatrics and Child Health 1998;34(4):330‐4. [CFGD Register: PE88g]
Button BM, Olinsky A, Catto‐Smith A, Story I. The effects of standard and modified physiotherapy positions and states of arousal including non‐nutritive sucking, crying and sleep on gastroesophageal reflux in young infants with CF [abstract}. Pediatric Pulmonology 1999;28 (Suppl 19):289. [CFGD Register: PE88h]
Button BM, Phelan P, Olinsky AD, Catto‐Smith AG, Heine RG, Ditchfield M, et al. The five year follow‐up of two groups of newly diagnosed infants with CF randomized to receive standard or modified physiotherapy during infancy [abstract]. Pediatric Pulmonology 2000;30 (Suppl 20):301‐2. [CFGD Register: PE88c]

Castile 1998 {published data only}

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 Pulmonolgy 1998;26 (Suppl 17):329. [CFGD Register: PE93a]
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):24‐8. [CFGD Register: PE93b]

Castle 1994 {published data only}

Castle T, Metcalfe C, Knox A, Nottingham City Hospital HRdNUK. A comparison between the active cycle of breathing technique (A.C.B.T.) and positive expiratory pressure (PEP) mask plus A.C.B.T. on sputum production and lung volumes in adults with Cystic Fibrosis [abstract]. Proceedings of the 19th European Cystic Fibrosis Conference; 1994. 1994:O17.

Cegla 1993 {published data only}

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):636‐9.

Cerny 1989 {published data only}

Cerny FJ. Relative effects of bronchial drainage and exercise for in‐hospital care of patients with cystic fibrosis. Physical Therapy 1989;69(8):633‐9.

Chatham 1998 {published data only}

Chatham K, Nixon LS, Ionescu AA, Garwood R, Premier G, Shale DJ. Increased sputum expectoration in cystic fibrosis patients after repeated resisted mueller manoeuvres [abstract]. Pediatric Pulmonology 1998;26 (Suppl 17):348.
Chatham K, Nixon LS, Ionescu AA, Shale DJ. Repeated inspiratory manoeuvres against a fixed resistance with biofeedback is more effective than standard chest physiotherapy in aiding sputum expectoration in cystic fibrosis [abstract]. Pediatric Pulmonology 1999;28 (Suppl 19):289.

Chatham 2004 {published data only}

Chatham K, Ionescu AA, Nixon LS, Shale DJ. A short‐term comparison of two methods of sputum expectoration in cystic fibrosis. European Respiratory Journal 2004;23(3):435‐9. [CFGD Register: PE149]

Cochrane 1977 {published data only}

Cochrane GM, Webber BA, Clarke SW. Effects of sputum on pulmonary function. British Medical Journal 1977;2:1181‐3.

Costantini 1998 {published data only}

Costantini D, Brivio A, Brusa D, Delfino R, Fredella C, Russo M, et al. PEP‐mask versus postural drainage in CF infants a long‐term comparative trial [abstract]. Pediatric Pulmonology 2001;32 (Suppl 22):308. [CFGD Register: PE94c]
Costantini D, Brivio A, Brussa D, Delfino R, Fredella C, Russo MC, et al. PEP‐mask versus postural drainage in CF infants a long‐term comparative trial [abstract]. Abstracts of the 24th European Cystic Fibrosis Conference; 2001 June 6‐9; Vienna. 2001:P100. [CFGD Register: PE94b]
Costantini D, Brivio A, Delfino R, Sguera A, Brusa D, Padoan R, Giunta A. PEP mask versus postural drainage in CF infants [abstract]. Pediatric Pulmonology 1998;26 (Suppl 17):342. [CFGD Register: PE94a]

Darbee 1990 {published data only}

Dadparvar S, Darbee J, Jehan A, Bensel K, Slizofski WJ, Holsclaw D. Tc‐DIPA aerosol ventilation evaluates the effectiveness of PEP mask in the treatment of cystic fibrosis [abstract]. European Respiratory Journal 1995;8(Suppl 19):177s.
Darbee J, Dadparvar S, Bensel K, Jehan A, Watkins M, Holsclaw D. Radionuclide assessment of the comparative effects of chest physical therapy and positive expiratory pressure mask in cystic fibrosis [abstract]. Pediatric Pulmonology 1990;9 (Suppl 5):251.

Darbee 2005 {published data only}

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, Abstract no. 378. [CFGD Register: PE169a]
Darbee JC, Kanga JF, Ohtake PJ. Physiologic evidence for high‐frequency chest wall oscillation and positive expiratory pressure breathing in hospitalized subjects with cystic fibrosis. Physical Therapy 2005;85(12):1278‐89. [CFGD Register: PE169b]

Davidson 1988 {published data only}

Davidson AGF, McIlwaine PM, Wong TK, Nakielna EM, Pirie GE. Physiotherapy in Cystic Fibrosis: A comparative trial of positive expiratory pressure, autogenic drainage and conventional percussion and drainage techniques [abstract]. Pediatric Pulmonology 1988;5 (Suppl 2):137.
McIlwaine PM, Davidson AGF. Comparison of positive expiratory pressure and autogenic drainage with conventional percussion and drainage therapy in the treatment of cystic fibrosis [abstract]. Proceedings of the 17th European Cystic Fibrosis Conference; 1991 June 18‐21; Copenhagen. 1991:S8.4.
McIlwaine PM, Davidson AGF, Wong LTK, Pirie GE, Nakielna EM. Comparison of positive expiratory pressure and autogenic drainage with conventional percussion and drainage therapy in the treatment of cystic fibrosis [abstract]. Proceedings of the Tenth International Cystic Fibrosis Congress; 1988 March 5‐10; Sydney. 1988:R(d)3.

Davidson 1992 {published data only}

Davidson AGF, Wong LTK, Pirie GE, McIlwaine PM. Long‐term comparative trial of conventional percussion and drainage physiotherapy versus autogenic drainage in cystic fibrosis [abstract]. Proceedings of the Sixth North American Cystic Fibrosis Conference; 1992. 1992:235.
McIlwaine PM, Wong LTK, Pirie GE, Davidson AGF. Long‐term comparative trial of conventional percussion and drainage physiotherapy versus autogenic drainage in cystic fibrosis [abstract]. Proceedings of the 11th International Cystic Fibrosis Congress; 1992. 1992.

Davidson 1998 {published data only}

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]. Proceedings of the 22nd European Cystic Fibrosis Conference; 1998 June 13‐18; Berlin. 1998:71.
McIlwaine PM, Wong LT, Peacock D, Davidson AGF. Long‐term comparative trial of positive expiratory pressure (flutter) physiotherapy in the treatment of cystic fibrosis. Journal of Pediatrics 2001;138(6):845‐50.
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 techniques [abstract]. Pediatric Pulmonology 1997;Suppl 14:299.

Davies 2012 {published data only}

Davies GA, Banks AE, Agent P, Osman LP, Bilton D, Hodson ME. The use of high frequency chest wall oscillation during an acute infective pulmonary exacerbation of cystic fibrosis [abstract]. Pediatric Pulmonology 2012;47 (Suppl 35):366, Abstract no: 396. [CFGD Register: PE197]

de Boeck 1984 {published data only}

de Boeck C, Zinman R. Cough Versus Chest Physiotherapy. A comparison of the acute effects on pulmonary function in patients with cystic fibrosis. American Review Respiratory Disease 1984;129:182‐4.

Delk 1994 {published data only}

Delk KK, Gevirtz R, Hicks DA, Carden F, Rucker R. The effects of biofeedback assisted breathing retraining on lung functions in patients with cystic fibrosis. Chest 1994;105(1):23‐8.

Desmond 1983 {published data only}

Desmond KJ, Schwenk WF, Thomas E, Beaudry PH, Coates AL. Immediate and long‐term effects of chest physiotherapy in patients with cystic fibrosis. Journal of Pediatrics 1983;103(4):538‐42.

Dosman 2003 {published data only}

Dosman CF, Zuberbuhler PC, Tabak JI, Jones RL. Effects of positive end‐expiratory pressure on oscillated volume during high frequency chest compression in children with cystic fibrosis. Canadian Respiratory Journal 2003;10(2):94‐8. [CENTRAL: 448688; CFGD Register: PE144; CRS: 5500100000002353]

Dunn 2013 {published data only}

Dunn C, Davies Z, Everson C, Zirbes J, Kim L, Milla C. Study of acute effects on pulmonary function and sputum production with high frequency chest oscillation (HFCWO) and postural drainage aided by handheld percussion (P‐HP) [abstract]. Pediatric Pulmonology 2013;48 Suppl 36:359, Abstract no: 421. [CENTRAL: 887110; CFGD Register: PE205b; CRS: 5500125000000287]
Dunn C, Davies Z, Kim L, Zirbes J, Everson C, Milla C. Comparison of acute effects of conventional high frequency chest oscillation (HFCWO) and hand held percussor (Electro‐Flo 5000) for airway clearance in cystic fibrosis patients [abstract]. Journal of Cystic Fibrosis 2013;12 Suppl 1:S103, Abstract no: 215. [CENTRAL: 875003; CFGD Register: PE205a; CRS: 5500100000011676]

Elkins 2000 {published data only}

Elkins MR, Ellis ER, Badr C. The effect of gravity assisted drainage (postural drainage) positions and other body positions on huff and cough strength [abstract]. Pediatric Pulmonology 2000;30 (Suppl 20):302.

Fainardi 2011 {published data only}

Fainardi V, Longo F, Faverzani S, Tripodi MC, Chetta A, Pisi G. Short‐term effects of high‐frequency chest compression and positive expiratory pressure in patients with cystic fibrosis. Journal of Clinical Medicine Research 2011;3(6):279‐84. [CENTRAL: 983057; CFGD Register: PE211; CRS: 5500125000000625; PUBMED: 22393338]

Falk 1984 {published data only}

Falk M, Kelstrup M, Andersen JB, Kinoshita T, Falk P, Stovring S, et al. Improving the ketchup bottle method with positive expiratory pressure, PEP, in cystic fibrosis. European Journal of Respiratory Disease 1984;65(6):423‐32.

Falk 1988 {published data only}

Falk M, Kelstrup M, Andersen JB, Pedersen SS, Rossing I, Dirksen H. PEP treatment or physical exercise. Effects on secretions expectorated and indices of central and peripheral airway function A controlled study [abstract]. Proceedings of the 10th International Cystic Fibrosis Congress; 1988 March 5‐10; Sydney. 1988:P. & E. (o)1.

Fauroux 1999 {published data only}

Fauroux B, Boule M, Lofaso F, Zerah F, Clement A, Harf A, et al. Chest physiotherapy in cystic fibrosis: improved tolerance with nasal pressure support ventilation. Pediatrics 1999;103(3):658‐9.

Gaskin 1998 {published data only}

Gaskin L, Corey M, Shin J, Reisman JJ, Thomas J, Tullis DE. Long term trial of conventional postural drainage and percussion vs. positive expiratory pressure [abstract]. Pediatric Pulmonology 1998;26 (Suppl 17):345.

Gayer 1988 {published data only}

Gayer DA, Hagemann V, Murphy K, University of Missouri CMU. Sleep of children with cystic fibrosis [abstract]. Proceedings of the Tenth International Cystic Fibrosis Congress; 1988 March 5‐10; Sydney. 1988:R(d)8.

Giles 1995 {published data only}

Giles DR, Wagener JS, Accurso FJ, Butler Simon N. Short‐term effects of postural drainage with clapping vs autogenic drainage on oxygen saturation and sputum recovery in patients with cystic fibrosis. Chest 1995;108(4):952‐4.

Giles 1996 {published data only}

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 Sputum Recovery in Cystic Fibrosis [abstract]. Pediatric Pulmonology 1996;Suppl 13:354.

Gondor 1999 {published data only}

Gondor M, Nixon PA, Mutich R, Rebovich P, Orenstein DM. Comparison of the flutter device and chest physical therapy in the treatment of cystic fibrosis pulmonary exacerbation. Pediatric Pulmonology 1999;28(4):255‐60.
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;22:307, Abstract no. 355.

Gotz 1995 {published data only}

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.

Grasso 2000 {published data only}

Grasso MC, Button BM, Allison DJ, Sawyer SM. Benefits of music therapy as an adjunct to chest physiotherapy in infants and toddlers with cystic fibrosis. Pediatric Pulmonology 2000;29(5):371‐81.
Grasso MC, Button BM, Sawyer SM, Allison DJ. Music: meeting the challenge of adherence to chest physiotherapy for infants and toddlers with cystic fibrosis [abstract]. Pediatric Pulmonolgy 1998;26 (Suppl 17):397.

Grzincich 2008 {published data only}

Grzincich GL, Longon F, Faverzani S, Chetta A, Spaggiari C, Pisi G. Short‐term effects of high‐frequency chest compression (HFCC) and positive expiratory pressure (PEP) in adults with cystic fibrosis [abstract]. Proceedings of European Respiratory Society Annual Congress; 2008 Oct 4‐8; Berlin, Germany. 2008:502s. [CFGD Register: PE173]

Gursli 2013 {published data only}

Gursli S, Sandvik L, Skrede B, Stuge B. Individual efficacy of Cough Technique versus Forced Expiration Techinique in cystic fibrosis [abstract]. Journal of Cystic Fibrosis 2013;12 Suppl 1:S103, Abstract no: 214. [CENTRAL: 875195; CFGD Register: PE206; CRS: 5500100000011677]

Hare 2002 {published data only}

Hare KL, Hommick DN, Cucos D, Marks JH. The PercussiveTech HF device compared to standard chest physiotherapy in hospitalized patients with cystic fibrosis [abstract]. Pediatric Pulmonology 2002;34 (Suppl 24):316. [CFGD Register: PE139]

Hartsell 1978 {published data only}

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.

Hofmeyr 1986 {published data only}

Hofmeyr JL, Webber BA, Hodson ME. Evaluation of positive expiratory pressure as an adjunct to chest physiotherapy in the treatment of cystic fibrosis. Thorax 1986;41(12):951‐4.
Webber BA, Hofmeyr JL, Hodson ME, Batten JC. Evaluation of positive expiratory pressure as an adjunct to postural drainage [abstract]. Proceedings of the 13th Annual Meeting of the European Working Group for Cystic Fibrosis; 1985 Nov 3‐8; Jerusalem. 1985:95.

Holland 2003 {published data only}

Holland A, Denehy L, Ntoumenopoulos G, McMeeken J, Wilson J. Non‐invasive ventilation prevents inspiratory muscle fatigue and oxygen desaturation during airway clearance in adults with acute exacerbations of cystic fibrosis [abstract]. Proceedings of the Thoracic Society of Australia & New Zealand Annual Scientific Meeting; 2003 April 4‐9; Adelaide, Australia. 2003:Abstract no: P140. [CENTRAL: 460951; CFGD Register: PE143d; CRS: 5500100000002459]
Holland A, Denehy L, Ntoumenopoulos G, Naughton M, Wilson J. Non‐invasive ventilation prevents inspiratory muscle fatigue and oxygen desaturation during airway clearance in adults with acute exacerbations of cystic fibrosis [abstract]. Journal of Cystic Fibrosis 2003;2 (Suppl 1):S622. [CFGD Register: PE143a]
Holland A, Denehy L, Ntoumenopoulos G, Wilson J. Non‐invasive ventilation prevents inspiratory muscle fatigue and oxygen desaturation during airway clearance in adults with exacerbations of cystic fibrosis [abstract]. American Journal of Respiratory and Critical Care Medicine 2003;167:D041. [CENTRAL: 448692; CFGD Register: PE143b; CRS: 5500100000002357]
Holland AE, Denehy L, Ntoumenopoulos G, Naughton MT, Wilson JW. Non‐invasive ventilation assists chest physiotherapy in adults with acute exacerbations of cystic fibrosis. Thorax 2003;58(10):880‐4. [CENTRAL: 440550; CFGD Register: PE143c; CRS: 5500100000002327; PUBMED: 14514944]

Homnick 1995 {published data only}

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]. Pedaitric Pulmonology 1994;18 (Suppl 10):312.
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;20:50‐5.

Homnick 1998 {published data only}

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):993‐7.
Homnick DN, Marks JH. Comparison of the flutter device to standard chest physiotherapy in hospitalized patients with cystic fibrosis [abstract]. Pediatric Pulmonology 1996;6 (Suppl 13):308, Abstract no. 356.

Jacobs 1981 {published data only}

Jacobs M, Ben‐Zvi Z, Kattan M, Bonforte R. The effect of chest physical therapy on oxygen saturation in cystic fibrosis patients [abstract]. 22nd Cystic Fibrosis Club Abstracts. 1981:124.

Keller 2001 {published data only}

Keller H, Liniger W, Fopp A, Hoch M, Knopfli B. Effects of daily harmonica play during in‐hospital care of patients with cystic fibrosis [abstract]. Abstracts of the 24th European Cystic Fibrosis Conference; 2001 June 6‐9; Vienna. 2001:339.

Kerrebijn 1982 {published data only}

Kerrebijn KF, Veentjer R, Bonzet‐vd Water E. The immediate effect of physiotherapy and aerosol treatment on pulmonary function in children with cystic fibrosis. European Journal of Respiratory Disease 1982;63(1):35‐42.

Klig 1989 {published data only}

Klig S, Denning C, Jacoby J, Xia F, Gaerlan P, Bisberg D, et al. A biopsychosocial examination of two methods of pulmonary therapy [abstract]. Pediatric Pulmonology 1989;7 (Suppl 4):128.

Kluft 1996 {published data only}

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):271‐4.

Kofler 1994 {published data only}

Kofler AM, Belluscio M, Bressan T, Carlesi A, Leone P, Lucidi V, et al. PEP‐mask and active cycle of breathing techniques. What is better in children with Cystic Fibrosis [abstract]. Proceedings of the 19th European Cystic Fibrosis Conference; 1994. 1994:O66.

Kofler 1998 {published data only}

Kofler AM, Carlesi A, Cutrera R, Leone P, Lucidi V, Rosati S, et al. BiPAP versus PEP as chest physiotherapy in patients with cystic fibrosis [abstract]. Pediatric Pulmonology 1998;26 (Suppl 17):344.

Konstan 1994 {published data only}

Konstan MW, 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):689‐93.

Kraig 1995 {published data only}

Kraig R, Kirkpatrick KR, Howard D, Ter‐Pogossian M, Kollef MH. A direct comparison of manual 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.

Lagerkvist 2006 {published data only}

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 the 21st European Cystic Fibrosis Conference; 1997; Davos. 1997:132. [CFGD Register: PE897a]
Lagerkvist AL, Sten GM, 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):1154‐61. [CFGD Register: PE87b]

Langenderfer 1998 {published data only}

Langenderfer, B. Alternatives to percussion and postural drainage. A review of mucus clearance therapies: percussion and postural drainage, autogenic drainage, positive expiratory pressure, flutter valve, intrapulmonary percussive ventilation, and high‐frequency chest compression with the ThAIRapy Vest. Journal of Cardiopulmonary Rehabilitation 1998;18(4):283‐9.

Lannefors 1992 {published data only}

Lannefors L, Wollmer P. Mucus clearance in cystic fibrosis ‐ a comparison between postural drainage, PEP‐mask and physical exercise [abstract]. Proceedings of the 11th International Cystic Fibrosis Congress; 1992. 1992:AHP31.
Lannefors L, Wollmer P. Mucus clearance with three chest physiotherapy regimes in cystic fibrosis: a comparison between postural drainage, PEP and physical exercise. European Respiratory Journal 1992;5(6):748‐53.

Lindemann 1992 {published data only}

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):626‐30.

Lorin 1971 {published data only}

Lorin MI, Denning CR. Evaluation of postural drainage by measurement of sputum volume and consistency. American Journal of Physical Medicine 1971;50(5):215‐9.

Lyons 1992 {published data only}

Lyons E, Chatham K, Campbell IA, Prescott RJ. Evaluation of the flutter VRP1 device in young adults with cystic fibrosis [abstract]. Proceedings of the 11th International Cystic Fibrosis Conference; 1992. 1992:AHP30. [CFGD Register: PE60a]
Lyons E, Chatham K, Campbell IA, Prescott RJ. Evaluation of the flutter VRP1 device in young adults with cystic fibrosis [abstract]. Thorax 1992;47(3):237P. [CFGD Register: PE60b]

Maayan 1989 {published data only}

Maayan C, Bar Yishay E, Yaacobi T, Marcus Y, Katznelson D, Yahav Y, et al. Immediate effect of various treatments on lung function in infants with cystic fibrosis. Respiration 1989;55(3):144‐51. [CFGD Register: IB56]

Majaesic 1996 {published data only}

Majaesic CM, Montgomery M, Jones R, King M. Reduction in sputum viscosity using high frequency chest compressions (HFCC) compared to conventional chest physiotherapy (CCP) [abstract]. Pediatric Pulmonology 1996;22 (Suppl 13):308. [CFGD Register: PE73]

Marks 1999 {published data only}

Marks JH, Hare KL, Homnick D. The PercussiveTech HF device compared to standard chest physiotherapy in patients with cystic fibrosis [abstract]. Abstract book XIII Cystic Fibrosis Congress; 2000 June 4‐8; Stockholm. 2000:151. [CFGD Register: PE109b]
Marks JH, Hare KL, Homnick DN. Pulmonary function and sputum production in patients with cystic fibrosis: a pilot study comparing the percussivetech HF device and standard chest physiotherapy [abstract]. Pediatric Pulmonology 1999;28 (Suppl 19):290. [CFGD Register: PE109a]
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):1507‐11. [CFGD Register: PE109c]

Maxwell 1979 {published data only}

Maxwell M, Redmond A. Comparative trial of manual and mechanical percussion technique with gravity‐assisted bronchial drainage in patients with cystic fibrosis. Archives of Disease in Childhood 1979;54(7):542‐4.

McCarren 2006 {published data only}

McCarren B, Alison JA. Comparison of vibration to other physiotherapy interventions for secretion clearance [abstract]. European Respiratory Journal 2005;26(Suppl 49):497s. [CENTRAL: 593045; CFGD Register: PE160a; CRS: 5500100000003003]
McCarren B, Alison JA. Physiological effects of vibration in subjects with cystic fibrosis. European Respiratory Journal 2006;27(6):1204‐9. [CENTRAL: 562450; CFGD Register: PE160b; CRS: 5500100000002835; PUBMED: 16455834]

McDonnell 1986 {published data only}

McDonnell T, McNicholas WT, FitzGerald MX. Hypoxaemia during chest physiotherapy in patients with cystic fibrosis. Irish Journal of Medical Science 1986;155:345‐8. [CFGD Register: OV9]

McIlwaine 1997 {published data only}

Button B, Herbert R, Maher C. Positive expiratory pressure therapy better maintains pulmonary function than postural drainage and percussion in patients with cystic fibrosis [comment]. Australian Journal of Physiotherapy 1998;44(4):285‐6. [CFGD Register: PE54d]
McIlwaine PM, Wong LT, Peacock D, Davidson AG. Long‐term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis. Journal of Pediatrics 1997;131(4):570‐4. [CFGD Register: PE54c]
McIlwaine PM, Wong LTK, Peacock D, Davidson AGF. Long‐Term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis [abstract]. Pediatric Pulmonology 1995;20 (Suppl 12):268. [CFGD Register: PE54a]
McIlwaine PM, Wong LTK, Peacock D, Davidson AGF. Long‐term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis [abstract]. Proceedings of the 12th International Cystic Fibrosis Conference; 1996 June 16‐21; Jerusalem. 1996:S193. [CFGD Register: PE54b]

McIlwaine 2010 {published data only}

McIlwaine M, Wong LT, Chilvers M, Davidson GF. Long‐term comparative trial of two different physiotherapy techniques; postural drainage with percussion and autogenic drainage, in the treatment of cystic fibrosis. Pediatric Pulmonology 2010;45(11):1064‐9. [CFGD Register: PE47c]
McIlwaine PM, Wong LTK, Pirie GE, Davidson AGF. Long‐term comparative trial of conventional percussion and drainage physiotherapy versus autogenic drainage in cystic fibrosis [abstract]. Proceedings of 11th International Cystic Fibrosis Congress. 1992:AHP32. [CFGD Register: PE47b]
Wong LT, Pirie GE, McIlwaine PM. Long‐term comparative trial of conventional percussion and drainage physiotherapy versus autogenic drainage in cystic fibrosis [abstract]. Pediatric Pulmonology 1992;14(Supplement S8):298, Abstract 235. [CFGD Register: PE47a]

McIlwaine 2012 {published data only}

Alarie N, Agnew JL, McIlwaine M, Ratjen F, Davidson G, Lands LC. Canadian National Airway Clearance Study: how physically active are CF patients? [abstract]. Pediatric Pulmonology 2012;47 Suppl 35:367, Abstract no:398. [CFGD Register: PE187e]
Alarie N, Agnew LL, McIlwaine MP, Ratjen F, Davidson GF, Milner R, et al. Evaluation of physical activity using the habitual activity estimation scale (HAES) questionnaire in a multicenter study [abstract]. Journal of Cystic Fibrosis 2013;12 Suppl 1:S28, Abstract no: WS14.1. [CFGD Register: PE187f]
McIlwaine M, Agnew J, Alarie N, Ratjen F, Lands L, Milner R, et al. Canadian national airway clearance study: patient satisfaction with positive expiratory pressure versus high frequency chest wall oscillation [abstract]. Pediatric Pulmonology 2012;47(S35):367, Abstract no: 397. [CFGD Register: PE187b]
McIlwaine M, Agnew JL, Alarie N, Lands L, Ratjen F, Milner R, et al. Canadian national airway clearance study: positive expiratory pressure mask versus high frequency chest wall oscillation [abstract]. Journal of Cystic Fibrosis 2012;11(Suppl 1):S23, Abstract no: WS10.6. [CFGD Register: PE187a]
McIlwaine MP, Alarie N, Davidson GF, Lands LC, Ratjen F, Milner R, et al. Long‐term multicentre randomised controlled study of high frequency chest wall oscillation versus positive expiratory pressure mask in cystic fibrosis. Thorax 2013;68(8):746‐51. [CFGD Register: PE187c]
McIlwaine MP, Alarie N, Davidson GF, Lands LC, Ratjen F, Milner R, et al. Online Supplement to "Long‐term multicentre randomised controlled study of high frequency chest wall oscillation versus positive expiratory pressure mask in cystic fibrosis" [online]. Thorax 2013;68(8):746‐51. [CFGE Register: PE187d]
McIlwaine MP, Richmond M, Agnew JL, Alarie N, Lands L, Chilvers M, et al. Cost‐effectiveness of performing positive expiratory pressure versus high frequency chest wall oscillation [abstract]. Journal of Cystic Fibrosis 2014;13 Suppl 2:S11, Abstract no: WS5.6. [CFGD Register: PE187g]

Miller 1995 {published data only}

Hall DO, Miller S, Clayton CB, Nelson R. Chest physiotherapy in Cystic Fibrosis: A comparative study of autogenic drainage and the active cycle of breathing technique [abstract]. Proceedings of the 19th European Cystic Fibrosis Conference; 1994. 1994:O64.
Miller S, Hall DO, Clayton CB, Nelson R. Chest physiotherapy in cystic fibrosis (CF) a comparative study of autogenic drainage (AD) and active cycle of breathing technique (ACBT) (formerly FET) [abstract]. Pediatric Pulmonology 1993;16 (Suppl 9):240.
Miller S, Hall DO, Clayton CB, Nelson R. Chest physiotherapy in cystic fibrosis: A comparative study of autogenic drainage and the active cycle of breathing techniques with postural drainage. Thorax 1995;50(2):165‐9.

Milne 2004 {published data only}

Milne SM, Eales CJ. A pilot study comparing two physiotherapy techniques in patients with cystic fibrosis [abstract]. South African Journal of Physiotherapy 2004;60(2):3‐6. [CENTRAL: 593047; CFGD Register: PE161; CRS: 5500100000003005]

Morris 1982 {published data only}

Morris D, Barbero G, Konig P, Woodruff C, Kline J, Martinez R. The effect of mechanical and manual percussion on pulmonary function in cystic fibrosis patients [abstract]. 23rd Cystic Fibrosis Club Abstracts; 1982 May 14; Washington DC. 1982:135.

Mulholland 1994 {published data only}

Mulholland C, Lennon S, Graham R. Does prone positioning improve oxygen saturation in a patient with cystic fibrosis? An alternating‐treatment single case design. Physiotherapy Theory and Practice 1994;10:223‐33.

Murphy 1983 {published data only}

Murphy MB, Concannon D, Fitzgerald MX. Chest percussion: help or hindrance to postural drainage?. Irish Medical Journal 1983;76(4):189‐91.

Murphy 1988 {published data only}

Murphy K, Hagemann V, Morris‐Gayer D. Effects of chest physiotherapy on sleep onset in hospitalized cystic fibrosis patients [abstract]. Proceedings of the 10th International Cystic Fibrosis Congress; 1988 March 4‐10; Sydney. 1988:R(d)7.

Natale 1994 {published data only}

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):1789‐93.

Newhouse 1998 {published data only}

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 percussion ventilator and standard chest physiotherapy [abstract]. Pediatric Pulmonology 1995;20 (Suppl 12):269.
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):427‐32.

Oberwaldner 1986 {published data only}

Oberwaldner B, Evans JC, Zach MS. Forced expirations against a variable resistance: a new chest physiotherapy method in cystic fibrosis. Pediatric Pulmonology 1986;2(6):358‐67.

Oberwaldner 1991 {published data only}

Oberwaldner B, Theißl B, Rucker A, Zach MS. Chest physiotherapy in hospitalized patients with cystic fibrosis: a study of lung function effects and sputum production. European Respiratory Journal 1991;4(2):152‐8.

Orlik 2000 {published data only}

Orlik T. Evaluation of the efficiency of selected thoracic physiotherapy methods used in the treatment of patients with cystic fibrosis [Ocena metod autodren azu w wybranej grupie chorych na mukowiscydoze z uwzglednieniem czynnika strodowiskowego]. Medycyna Wieku Rozwojowego 2000;4(3):233‐46. [CFGD Register: PE140]

Orlik 2000a {published data only}

Orlik T. Evaluation of autodrainage methods in a selected group of cystic fibrosis patients with home environment factors taken into consideration. Medycyna wieku rozwojowego 2000;4(3):247‐59. [CFGD Register: PE141]

Orlik 2001 {published data only}

Orlik T, Sands D. Long‐term evaluation of effectiveness for selected chest physiotherapy methods used in the treatment of cystic fibrosis [Dlugofalowa ocean skutecznosci wybranych metod fizjoterapii klatki piersiowej stosowanych w leczeniu church na mukowiscydoze]. Medycyna Wieku Rozwojowego 2001;5(3):245‐57. [CFGD Register: PE125b]
Orlik T, Sands D. Long‐term study of efficiencies of selects physiotherapy methods used in the treatment of cystic fibrosis [abstract]. Abstracts of the 24th European Cystsic Fibrosis Conference; 2001 June 6‐9; Vienna. 2001:113. [CFGD Register: PE125a]

Osman 2010 {published data only}

Osman LP, Roughton M, Hodson ME, Pryor JA. High frequency chest wall oscillation in cystic fibrosis [abstract]. Journal of Cystic Fibrosis 2008;7 (Suppl 2):S73, Abstract no. 295. [CFGD Register: PE171a]
Osman LP, Roughton M, Hodson ME, Pryor JA. Short‐term comparative study of high frequency chest wall oscillation and European airway clearance techniques in patients with cystic fibrosis. Thorax 2010;65(3):196‐200. [CFGD Register: PE171b]

Padman 1999 {published data only}

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):13‐8.

Parker 1984 {published data only}

Parker RA, Webber BA, Sutton PP, Newman SP, Garland N, Lopez‐Vidriero MT, et al. Evaluation of three individual components of a postural drainage treatment [abstract]. Proceedings of the Ninth International Cystic Fibrosis Congress; 1984. 1984:2.13.

Parreira 2008 {published data only}

Parreira V, Pires S, Sulmonett N, Camargos P, Haddad J, Britto R. Positive expiratory pressure and lung function in cystic fibrosis patients [abstract]. European Respiratory Society Annual Congress; 2008 Oct 4‐8; Berlin, Germany. 2008:E1779. [CENTRAL: 679902; CFGD Register: PE212; CRS: 5500050000000051]

Parsons 1995 {published data only}

Parsons DW, Williams MT, Frick RA, Ellis ER, Martin AJ, Giles SE, et al. Chest physiotherapy: improvements in lung function and ventilation are associated with physiotherapy‐assisted treatment [abstract]. Pediatric Pulmonology 1995;20 (Suppl 12):271. [CFGD Register: PE57a]
Williams M, Parsons D, Martin A, Ellis E, Giles S, Staugas REM, et al. Chest physiotherapy (CPT) and cystic fibrosis: physiotherapist‐assisted treatment is more energy efficient [abstract]. Australian and New Zealand Journal of Medicine 1995;25:441. [CFGD Register: PE57c]
Williams M, Parsons D, Martin A, Giles S, Staugas REM. Energy expenditure during chest physiotherapy in normal and cystic fibrosis (CF) subjects [abstract]. Australia and New Zealand Journal of Medicine 1994;24:445. [CFGD Register: PE57b]
Williams MT, Parsons DW, Frick RA, Ellis ER, Martin AJ, Giles SE, et al. Acute respiratory infection in patients with cystic fibrosis with mild pulmonary impairment: comparison of two physiotherapy regimens. Australian journal of physiotherapy 2001;47(4):227‐36. [CFGD Register: PE57d]
Williams MT, Parsons DW, Frick RA, Ellis ER, Martin AJ, Giles SE, et al. Energy expenditure during physiotherapist‐assisted and self‐treatment in cystic fibrosis. Physiotherapy Theory and Practice 2000;16(2):57‐67. [CFGD Register: PE57e]

Patel 2013 {published data only}

Patel P, Fukushima L, Balekian A, Chou W, Lu A, Gali V, et al. Is Metaneb comparable to high frequency chest compression in the setting of a severe pulmonary exacerbation in adults with cystic fibrosis [abstract]. Pediatric Pulmonology 2013;48 Suppl 36:359, Abstract no: 420. [CENTRAL: 887112; CFGD Register: PE209; CRS: 5500125000000289]

Phillips 1998 {published data only}

Phillips GE, Pike SE, Rosenthal M, Bush A. Holding the baby: head downwards positioning for physiotherapy does not cause gastro‐oesophageal reflux. European Respiratory Journal 1998;12(4):954‐7.

Phillips 2004 {published data only}

Phillips GE, 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. [CFGD Register: PE114a]
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):71‐5. [CFGD Register: PE114b]

Pike 1999 {published data only}

Pike SE, Machin AC, Dix KJ, Pryor JA, Hodson ME. Comparison of flutter VRPI and forced expirations (FE) with active cycle of breathing techniques (ACBT) in subjects with cystic fibrosis (CF). The Netherlands Journal of Medicine 1999;54(Suppl):S55‐S56.

Placidi 2006 {published data only}

Placidi G, Cornacchia M, Cappelletti LM, Mastella G, Assael BM, Braggion C. Short‐term effects of positive airway pressure on sputum clearance by directed coughing: a cross‐over randomized study. Pediatric Pulmonology 2001;32 (Suppl 22):313, Abstract no. 416. [CFGD Register: PE128a]
Placidi G, Cornacchia M, Polese G, Zanolla L, Assael BM, Braggion C. Chest physiotherapy with positive airway pressure: a pilot study of short‐term effects on sputum clearance in patients with cystic fibrosis and severe airway obstruction. Respiratory Care 2006;51(10):1145‐53. [CFGD Register: PE128b]

Pollard 2000 {published data only}

Pollard K, Peckham D, Crafton K, McMunn E, Mee C. The effect of increased gravitational and centrifugal forces on sputum expectoration in adults with cystic fibrosis [abstract]. Abstract book XIIIth International Cystic Fibrosis Congress; 2000 June 4‐8; Stockholm. 2000:152.

Prasad 2005 {published data only}

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. [CENTRAL: 593029; CFGD Register: PE157a; CRS: 5500100000002990]

Pryor 1979a {published data only}

Hodson ME, Batten JC, Pryor JA, Webber BA, Brompton Hospital L. Evaluation of the forced expiration technique as an adjunct to postural drainage in the treatment of cystic fibrosis [abstract]. Proceedings of the Ninth European Cystic Fibrosis Conference; 1979 June 12‐13; Noordwijkerhout. 1979:57. [CFGD Register: PE78b]
Pryor JA, Webber BA, Hodson ME, Batten JC. Evaluation of the forced expiration technique as an adjunct to postural drainage in treatment of cystic fibrosis. British Medical Journal 1979;2(6187):417‐8. [CFGD Register: PE78a]

Pryor 1979b {published data only}

Pryor JA, Webber BA. An evaluation of the forced expiration technique as an adjunct to postural drainage. Physiotherapy 1979;65(10):304‐7. [CFGD Register: PE79]

Pryor 1981 {published data only}

Pryor JA, Parker RA, Webber BA. A comparison of mechanical and manual percussion as adjuncts to postural drainage in the treatment of cystic fibrosis in adolescents and adults. Physiotherapy 1981;67(5):140‐1. [CFGD Register: PE4]

Pryor 1990 {published data only}

Pryor JA, Webber BA, Hodson ME. Effect of chest physiotherapy on oxygen saturation in patients with cystic fibrosis. Thorax 1990;45(1):77.

Pryor 1994 {published data only}

Pryor JA, Webber BA, Hodson ME, Warner JO. The Flutter VRP1 as an adjunct to chest physiotherapy in Cystic Fibrosis [abstract]. Proceedings of the 11th International Cystic Fibrosis Congress; 1992. 1992:WP 102. [CFGD Register: PE25a]
Pryor JA, Webber BA, Hodson ME, Warner JO. The Flutter VRP1 as an adjunct to chest physiotherapy in cystic fibrosis. Respiratory Medicine 1994;88(9):677‐81. [CFGD Register: PE25b]

Pryor 2010 {published data only}

Pryor JA, Tannenbaum E, Scott SF, Burgess J, Cramer D, Gyi K, et al. Beyond postural drainage and percussion: Airway clearance in people with cystic fibrosis. Journal of Cystic Fibrosis 2010;9(3):187‐92. [CENTRAL: 759356; CFGD Register: PE164b; CRS: 5500050000000050; PUBMED: 20153269]

Reisman 1988 {published data only}

Reisman JJ, Rivington Law B, Corey M, Marcotte J, Wannamaker E, Harcourt D, et al. Role of conventional physiotherapy in cystic fibrosis [see comments]. Journal of Pediatrics 1988;113(4):632‐6.

Reix 2009 {published data only}

Reix P, Aubert F, Kassai B, Bige V, Bellon G. Better satisfaction of cystic fibrosis paediatric patients with autogenic drainage associated to exercise compared to conventional chest physiotherapy [abstract]. Journal of Cystic Fibrosis 2009;8(Suppl 2):S73, Abstract no: 293. [CFGD Register: PE183a]
Reix P, Aubert F, Werck‐Gallois MC, Toutain A, Mazzocchi C, Moreux N, et al. Exercise with incorporated expiratory manoeuvres was as effective as breathing techniques for airway clearance in children with cystic fibrosis: a randomised crossover trial. Journal of Physiotherapy 2012;58(4):241‐7. [CFGD Register: PE183b]

Rodriguez 2013 {published data only}

Rodriguez Hortal MC, Hjelte L. Non invasive ventilation as airway clearance technique compared to PEP in adult patients with cystic fibrosis [abstract]. Journal of Cystic Fibrosis 2013;12 Suppl 1:S18, Abstract no: WS9.4. [CENTRAL: 875000; CFGD Register: PE203; CRS: 5500100000011654]

Roos 1987 {published data only}

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 the 15th Annual Meeting of the European Working Group for Cystic Fibrosis; 1987. 1987.

Salh 1989 {published data only}

Salh W, Bilton D, Dodd M, Webb AK. Effect of exercise and physiotherapy in aiding sputum expectoration in adults with cystic fibrosis. Thorax 1989;44(12):1006‐8.

Samuelson 1994 {published data only}

Samuelson W, Woodward V, Lowe V. Utility of a dynamic air therapy bed vs. conventional chest physiotherapy in adult CF patients [abstract]. Pediatric Pulmonology 1994;18 (Suppl 10):313.

Sanchez 1999 {published data only}

Sanchez Riera H, Dapena Fernandez FJ, Gomez Dominguez F, Ortega Ruiz F, Elias Hernandez T, Montemayor Rubio T, et al. Comparative study of the efficacy of 2 respiratory physiotherapy protocols for patients with cystic fibrosis [Estudio comparativo de la eficacia de dos protocolos de fisioterapia respiratoria en pacientes con fibrosis quistica]. Archivos de bronconeumologia 1999;35(6):275‐9.

Scherer 1998 {published data only}

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):1019‐27.

Sokol 2012 {published data only}

Sokol G, Hakimi R, Better R, Efrati O. The short term effect of airway clearance using the "Cough Assist" on lung function in patients with cystic fibrosis [abstract]. Journal of Cystic Fibrosis 2012;11(Suppl 1):S104, Abstract no:188. [CFGD Register: PE196a]
Sokol G, Hakimi R, Vilozni D, Beter R, Rubinstein E, Larea Yona O, et al. The short term effect of the "cough assist" and "autogenic drainage" physiotherapy on lung function in patients with cystic fibrosis [abstract]. Pediatric Pulmonology 2012;47 (Suppl 35):365, Abstract no: 394. [CFGD Register: PE196b]

Sontag 2010 {published data only}

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, Abstract no. 363. [CFGD Register: PE152a]
Modi AC, Cassedy AE, Quittner AL, Accurso F, Sontag M, Koenig JM, et al. Trajectories of adherence to airway clearance therapy for patients with cystic fibrosis. Journal of Pediatric Psychology 2010;35(9):1028‐37. [CFGD Register: PE152e]
Modi AC, Sontag MK, Koenig JM, Accurso FJ, Quittner AL, Investigators & 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 1):S97, Abstract no. 436. [CFGD Register: PE152c]
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, Abstract no. 364. [CFGD Register: PE152b]
Sontag MK, Quittner AL, Modi AC, Koenig JM, Giles D, Oermann CM, et al. Lessons learned from a randomized trial of airway secretion clearance techniques in cystic fibrosis. Pediatric Pulmonology 2010;45(3):291‐300. [CFGD Register: PE152d]

Steen 1991 {published data only}

Steen HJ, Redmond AO, O'Neill D, Beattie F. Evaluation of the PEP mask in cystic fibrosis. Acta Paediatrica Scandinavia 1991;80(1):51‐6.
Steen HJ, Redmond AOB, O' Neill D, Beattie F. Has the PEP mask a role in the management of teenage patients? [abstract]. Proceedings of the 13th Annual Meeting of the European Working Group for Cystic Fibrosis; 1985 Nov 3‐8; Jeusalem. 1985:94.

Steven 1992 {published data only}

Steven MH, Pryor JA, Webber BA, Hodson MR. Physiotherapy versus cough alone in the treatment of cystic fibrosis. New Zealand Journal of Physiotherapy 1992;20:31‐7. [CFGD Register: PE65]

Stites 2006 {published data only}

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):712‐7. [CFGD Register: PE162]

Sutton 1985 {published data only}

Sutton PP, Lopez‐Vidriero MT, Pavia D, Newman SP, Clay MM, Webber B, et al. Assessment of percussion, vibratory shaking and breathing exercises in chest physiotherapy. European Journal of Respiratory Disease 1985;66(2):147‐52.

Tannenbaum 2001 {published data only}

Tannenbaum E, Prasad SA, Dinwiddie R, Main E. Chest physiotherapy during anesthesia for children with cystic fibrosis: effects on respiratory function. Pediatric Pulmonology 2007;42(12):1152‐8.
Tannenbaum E, Prasad SA, Main E, Stocks J. The effect of chest physiotherapy on cystic fibrosis patients undergoing general anaesthesia for an elective surgical procedure [abstract]. Pediatric Pulmonology 2001;32 (Suppl 22):315.

Tecklin 1976 {published data only}

Holsclaw DS, Tecklin JS. The effectiveness of bronchial drainage and aerosol inhalation in cystic fibrosis. Cystic Fibrosis 1977:230‐8.
Tecklin JS, Holsclaw DS. Bronchial drainage with aerosol medications in cystic fibrosis. Physical Therapy 1976;56(9):999‐1003.

Thomas 1995 {published data only}

Thomas J, DeHueck A, Kleiner M, Newton J, Crowe J, Mahler S. To vibrate or not to vibrate: usefulness of the mechanical vibrator for clearing bronchial secretions. Physiotherapy Canada 1995;47:120‐5.

Tonnesen 1982 {published data only}

Tonnesen P, Kelstrup M. Self‐administered positive end expiratory pressure (PEEP) using a face mask as an alternative to conventional lung [Selvadministeret positivt sluteksspiratorisk tryk (PEEP) pa maske som alternativ til konventionel lungefysioterapi]. Ugeskrift for Laeger 1982;144(21):1532‐6. [CFGD Register: PE5]

Toral 1997 {published data only}

Toral J, Sanchez H, Ortega F, Elfas T, del Castillo D, Montemayor T. Comparative study of two treatments of respiratory physiotherapy for cystic fibrosis [abstract] [Estudio comparativo de dos tratamientos de fisioterapia respiratoria en la fibrosis qufstica]. Archivos de Bronconeumologia 1997;33:39. [CFGD Register: PE119]

Tugay 2000 {published data only}

Tugay U, Inal Ince D, Savci S, Arikan H, Tunali N, Demirel H, Ozcelik U, Kiper N, Gocmen A. Effects of Flutter valve therapy on pulmonary functions and oxygen saturation in cystic fibrosis [abstract]. Abstracts XIIIth International Cystic Fibrosis Congress; 2000 June 4‐8; Stockholm. 2000:151.

Tyrrell 1986 {published data only}

Tyrrell JC, Hiller EJ, Martin J. Face mask physiotherapy in cystic fibrosis. Archives of Disease in Childhood 1986;61(6):598‐600. [CFGD Register: PE31a]
Tyrrell JC, Martin J, Hiller EJ. 'PEP' mask physiotherapy in cystic fibrosis [abstract]. Proceedings of the 13th Annual Meeting of the European Working Group for Cystic Fibrosis; 1985 Nov 3‐8; Jerusalem. 1985:23. [CFGD Register: PE31b]

van Asperen 1987 {published data only}

van Asperen PP, Jackson L, Hennessy P, Brown J. Comparison of a positive expiratory pressure (PEP) mask with postural drainage in patients with cystic fibrosis. Australian Paediatric Journal 1987;23(5):283‐4.

Van Ginderdeuren 2000 {published data only}

van Ginderdeuren F, Malfroot A, Opdeweegh L, Dab I. Intrapulmonary percussive ventilation (IPV) in cystic fibrosis [abstract]. Abstract XIIIth international cystic fibrosis congress; 2000 June 4‐8; Stockholm. 2000:152.

Van Ginderdeuren 2008 {published data only}

Van Ginderdeuren F, Verbanck S, Van Cauwelaert K, Vanlaethem S, Schuermans D, Vincken W, et al. Chest physiotherapy in cystic fibrosis: short‐term effects of autogenic drainage preceded by wet inhalation of saline versus autogenic drainage preceded by intrapulmonary percussive ventilation with saline. Respiration 2008;76(2):175‐80. [CFGD Register: BD178]

van Hengstum 1987 {published data only}

Van Hengstum M, Festen J, Beurskens C, Hankel M, Van den Broek W, Buijs W, et al. The effect of positive expiratory pressure (PEP) versus forced expiration technique (FET) on tracheobronchial clearance in chronic bronchitics [abstract]. Proceedings of the 15th Annual Meeting of the European Working Group for Cystic Fibrosis. 1987. [CFGD Register: PE35]

van Hengstum 1988 {published data only}

van Hengstum M, Festen J, Beurskens C, Hankel M, Beekman F, Corstens F. Conventional physiotherapy and forced expiration manoeuvres have similar effects on tracheobronchial clearance. European Respiratory Journal 1988;1(8):758‐61. [CFGD Register: PE64]

Vanlaethem 2008 {published data only}

Vanlaethem S, Van Ginderdeuren F, Eyns H, Malfroot A. Influence of inhaled hypertonic saline combined with airway clearance on SpO2, heart rate, dyspnoea and wet sputum weight in hospitalised CF patients [abstract]. Journal of Cystic Fibrosis 2008;7(Suppl 2):S71. [CFGD Register: BD129]

van Winden 1998 {published data only}

van Winden CM, VisserA, 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):143‐7.
van Winden CMQ, Visser A, Hop W, Sterk PJ, Beckers S, de Jongste JC. Effects of flutter and PEP‐MASK on expectoration and lung function in cystic fibrosis [abstract]. Proceedings of the 12th International Cystic Fibrosis Conference; 1996. 1996:S275.

Verboon 1986 {published data only}

Verboon JM, Bakker W, Sterk PJ. The value of the forced expiration technique with and without postural drainage in adults with cystic fibrosis. European Journal of Respiratory Diseases 1986;69(3):169‐74.
Verboon JML, Bakker W, Dijkman JH. Effect of the forced expiration technique and postural drainage in adults with cystic fibrosis [abstract]. Proceedings of the Ninth International Cystic Fibrosis Congress; 1984. 1984:2.17.
Verboon JML, Bakker W, Sterk PJ. De waarde van de 'forced expiration technique' (FET). Nederlands Tijdschrift voor Fysiotherapie 1987;97:62‐4.

Warwick 1990 {published data only}

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;9 (Suppl 5):177.

Warwick 1991 {published data only}

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):265‐71.

Warwick 2004 {published data only}

Warwick WJ, Wielinski CL, Hansen LG. Comparison of expectorated sputum after manual chest physical therapy and high‐frequency chest compression. Biomedical Instrumentation Technology 2004;38(6):470‐5. [CFGD Register: PE153]

Webber 1985 {published data only}

Webber BA, Parker RA, Hofmeyr JL, Hodson ME. Evaluation of self‐percussion during postural drainage using the forced expiration technique (FET) [abstract]. Proceedings of the Ninth International Cystic Fibrosis Congress; 1984. 1984:2.12.
Webber BA, Parker R, Hofmeyr J, Hodson M. Evaluation of self‐percussion during postural drainage using the forced expiration technique. Physiotherapy Practice 1985;1:42‐5.

West 2010 {published data only}

West K, Wallen M, Follett J. Acapella vs. PEP mask therapy: a randomised trial in children with cystic fibrosis during respiratory exacerbation. Physiotherapy Theory and Practice 2010;26(3):143‐9. [CENTRAL: 753270; CFGD Register: PE213; CRS: 5500050000000049; PUBMED: 20331370]

Wheatley 2013 {published data only}

Wheatley CM, Baker SE, Daines C, Phan H, Morgan WJ, Snyder EM. Influence of the vibralung device on pulmonary function and sputum expectoration in patients with cystic fibrosis [abstract]. Pediatric Pulmonology 2013;48 Suppl 36:357, Abstract no: 416. [CENTRAL: 887111; CFGD Register: PE208; CRS: 5500125000000288]

White 1997 {published data only}

Stiller K. Are thoracic expansion exercises necessary during the active cycle of breathing techniques for adult cystic fibrosis patients? [abstract]. Proceedings of the 12th International Cystic Fibrosis Conference; 1996. 1996:S275. [CFGD Register: PE61a]
White D, Stiller K, Willson K. The role of thoracic expansion exercises during the active cycle of breathing techniques. Physiotherapy Theory and Practice 1997;13:155‐62. [CFGD Register: PE61b]

Wilson 1995 {published data only}

Wilson GE, Baldwin AL, Walshaw MJ. Chest physiotherapy in patients with cystic fibrosis (CF) ‐ a comparison of traditional methods with the active cycle of breathing [abstract]. Proceedings of the 20th European Cystic Fibrosis Conference; 1995 June; Brussels. 1995:P58.

Wong 1999 {published data only}

Wong LT, McIlwaine PM, Davidson AG, Lillquist YP. Gastroesophageal reflux during chest physiotherapy: a comparison of positive expiratory pressure and postural drainage with percussion [abstract]. Pediatric Pulmonology 1999;28 (Suppl 19):288. [CFGD Register: PE108a]
Wong LTK, McIllwaine PM, Davidson AGF. Gastroesphageal reflux during chest physiotherapy: a comparison of positive expiratory pressure and postural drainage with percussion [abstract]. Abstract book XIIIth International Cystic Fibrosis Congress; 2000 June 4‐8; Stockholm. 2000:130. [CFGD Register: PE108b]

Wordsworth 1996 {published data only}

Wordsworth AE, McDonald A, Lacy D, Smyth R. Bronchial lavage in cystic fibrosis patients during general anaesthesia for elective surgery [abstract]. Pediatric Pulmonology 1996;22 (Suppl 13):362.

Zapletal 1983 {published data only}

Zapletal A, Stefanova J, Horak J, Vavrova V, Samanek M. Chest physiotherapy and airway obstruction in patients with cystic fibrosis ‐ a negative report. European Journal of Respiratory Disease 1983;64(6):426‐33.

Znotina 2000 {published data only}

Znotina I, Svabe V. The effectiveness of physiotherapy for children with cystic fibrosis [abstract]. Abstract book XIIIth International Cystic Fibrosis Congress; 2000 June 4‐8; Stockholm. 2000:152.

Cantin 1995

Cantin A. Cystic fibrosis lung inflammation: Early, sustained, and severe. American Journal of Respiratory and Critical Care Medicine 1995;151:939‐41.

Elbourne 2002

Elbourne DR, Altman DG, Higgins JPT, Curtin F, Worthington HV, Vail A. Meta‐analyses involving cross‐over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140‐9.

Elkins 2006

Elkins M, Jones A, van der Schans CP. 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]

Higgins 2003

Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta‐analyses. BMJ 2003;327(7414):557‐60.

Higgins 2011

Higgins JPT, Altman DG (editors). Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.

Jadad 1996

Jadad AR, Moore A, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary?. Controlled Clinical Trials 1996;17(1):1‐12.

Konstan 1997

Konstan MW, Berger M. Current understanding of the inflammatory process in cystic fibrosis: onset and etiology. Pediatric Pulmonology 1997;24:137‐42.

Lee 2013

Lee AL, Burge A, Holland AE. Airway clearance techniques for bronchiectasis. Cochrane Database of Systematic Reviews 2013, Issue 5. [DOI: 10.1002/14651858.CD008351.pub2]

Main 2005

Main E, Prasad A, van der Schans CP. 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]

McKoy 2012

Mckoy NA, Saldanha IJ, Odelola OA, Robinson KA. Active cycle of breathing technique for cystic fibrosis. Cochrane Database of Systematic Reviews 2012, Issue 12. [DOI: 10.1002/14651858.CD007862.pub3]

Morrison 2009

Morrison L, Agnew J. Oscillating devices for airway clearance in people with cystic fibrosis. Cochrane Database of Systematic Reviews 2009, Issue 1. [DOI: 10.1002/14651858.CD006842.pub2]

Osadnik 2012

Osadnik CR, McDonald CF, Jones AP, Holland AE. Airway clearance techniques for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews 2012, Issue 3. [DOI: 10.1002/14651858.CD008328.pub2]

Prasad 1998

Prasad A, Main E. Finding evidence to support airway clearance techniques in cystic fibrosis. Disability and Rehabilitation 1998;20:235‐46.

Prasad 2008

Prasad A, Dhouieb E. Clinical guidance for the physiotherapy management of screened infants with cystic fibrosis. ACPCF Physiotherapy Guidance Paper no. 42008.

Review Manager 2011 [Computer program]

The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.

Thomas 1995a

Thomas J, Cook DJ, Brooks D. Chest physical therapy management of patients with cystic fibrosis. A meta‐analysis. American Journal of Respiratory and Critical Care Medicine 1995;151:846‐50.

van der Schans 1996

Schans CP van der, Mark Th W van der, Rubin BK, Postma DS, Koeter GH. Chest physical therapy: mucus mobilizing techniques. In: Bach JR editor(s). Pulmonary Rehabilitation. Philadelphia, USA: Hanley & Belfus, 1996:229‐46.

Williams 1949

Williams EJ. Experimental designs balanced for the estimation of residual effects of treatments. Australian Journal of Scientific Research 1949;2:149‐56.

Zach 1990

Zach MS. Lung disease in cystic fibrosis ‐ an updated concept. Pediatric Pulmonology 1990;8:188‐202.

References to other published versions of this review

van der Schans 2000

van der Schans CP, Prasad A, Main E. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis. Cochrane Database of Systematic Reviews 2000, Issue 2. [DOI: 10.1002/14651858.CD001401]

Warnock 2013

Warnock L, Gates A, van der Schans CP. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis. Cochrane Database of Systematic Reviews 2013, Issue 9. [DOI: 10.1002/14651858.CD001401.pub2]

Characteristics of studies

Characteristics of included studies [ordered by study ID]

Braggion 1995

Methods

Cross‐over study, interventions given in random order.

Participants

16 patients with CF (8 males; 8 females).
Mean (SD) age 20.3 (4) years.

Mean (SD) FEV1% predicted 61.7% (17%).

Interventions

High‐frequency chest compression.

Postural drainage, breathing exercises, vibrations, manual percussion.

PEP breathing.

Control.

Outcomes

Wet and dry weight expectorated mucus; pulmonary function tests (FVC, FEV1, FEF25‐75%); subjective assessment.

Notes

Measurement 30 minutes after intervention.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Low risk

Random order of the interventions performed according to Latin square design described by Williams (Williams 1949). In order to balance distribution between sexes, two 4 x 4 Latin squares were used for male participants and two for female participants.

Allocation concealment (selection bias)

Unclear risk

Not discussed.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Interventions did not allow participants or clinicians to be blinded, not discussed whether outcome assessors were blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

No mention of any dropouts.

Selective reporting (reporting bias)

Low risk

Protocol not available for comparison, but data on expected outcomes reported. Immediate measurement after intervention.

Other bias

Unclear risk

Funding source not reported, however potential sources not thought to introduce a significant risk of introducing bias.

Unknown whether patients naive to all interventions prior to study.

Elkins 2005

Methods

Randomised cross‐over study.

Participants

12 adults with CF, gender split not stated.

Mean (range) age 25 (17 ‐ 34) years.

Mean (range) FEV1 % predicted 53 (16 ‐ 88).

Interventions

Participants inhaled 99mTechnetium‐labelled sulphur colloid aerosol matching a target breathing pattern followed by 20 min of one of 4 interventions (randomised):

  • postural drainage with percussion;

  • PEP;

  • oscillating PEP;

  • matched cough (voluntary coughing to a maximum number of times coughed during previous interventions).

Then on 5th study period participants voluntarily coughed the maximum number of times they had coughed during any of the previous interventions.

Outcomes

Mean % radioactive tracer clearance (10 minute baseline dynamic SPECT scan after inhalation and scan at 90 min).

Notes

Study supported by NHMRC.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Abstract states random order of the interventions, but no details of randomisation method given.

Allocation concealment (selection bias)

Unclear risk

Not discussed.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Not possible to blind participants or clinicians, not discussed if outcome assessors blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

No mention of any dropouts.

Selective reporting (reporting bias)

Unclear risk

Protocol not available for comparison and insufficient information to assess whether all outcomes reported.

Other bias

Unclear risk

Washout period unclear, not stated if interventions took place on same day or different days.

Unknown whether patients naive to all interventions prior to study.

Falk 1993

Methods

Cross‐over study, interventions given in random order.

Participants

12 patients with CF, gender split not stated.

Age and disease severity also not reported.

Interventions

FET, postural drainage.

FET, PEP breathing.
Control.

Outcomes

Radioactive tracer clearance.

Notes

Measurements 30 minutes, 1 hour, 2 hours and 24 hours after intervention.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Paper states random order of the interventions, but no details of randomisation method given.

Allocation concealment (selection bias)

Unclear risk

Not discussed.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Interventions did not allow participants or clinicians to be blinded, not discussed whether outcome assessors were blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

No mention of any dropouts.

Selective reporting (reporting bias)

Unclear risk

Protocol not available for comparison and insufficient information to assess whether all outcomes reported.

Other bias

Unclear risk

Funding source not reported, however potential sources not thought to introduce a significant risk of introducing bias.

Unknown whether patients naive to all interventions prior to study.

Jarad 2010

Methods

Cross‐over study, interventions given in random order.

Participants

19 adults with CF (11 males; 8 females).

Mean (SD) age 24 (4.8) years.

Interventions

HAT (this group excluded from the current review as not a recognised ACT).

Flutter.

Control (sitting in a bath with sham form of HAT).

Outcomes

Expectorated sputum wet and dry weight.

FEV1, FVC, FEF25‐75%, FEF75.

Patient questionnaire.

Notes

Measurements at 60 min post treatment.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

States treatment order was randomised but no details of randomisation method reported.

Allocation concealment (selection bias)

Unclear risk

Not discussed.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Interventions did not allow participants or clinicians to be blinded, not discussed whether outcome assessors were blinded.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

There was one dropout reported following enrolment; this was due to time constraints. Complete data was presented for the remaining 18 participants.

Selective reporting (reporting bias)

High risk

Study protocol and methods section state SpO2, RR, HR and BP would be measured throughout the interventions, but there is no reference to this data in the results or discussion.

Other bias

Unclear risk

Funding source not reported, however paper states the authors had no conflict of interest.

HAT group excluded from this analysis therefore potential bias from equipment provision not relevant.

Unit of measurement for sputum weight not reported.

4/18 participants used flutter as usual main physiotherapy method prior to study.

Mortensen 1991

Methods

Cross‐over study, interventions given in random order on 3 occasions each separated by 48 hours.

Participants

10 patients with CF (6 male; 4 female).

Mean (SD) age 20 (3.4) years.

Median (range) FEV1% predicted 38.5% (26% ‐ 101%).

Interventions

20 min session of intervention immediately after ultrasonic nebulisation of 99mTC‐human albumin colloid:

‐ postural drainage, FET, thoracic expansion exercises, relaxation;
‐ PEP breathing, FET;
‐ control, spontaneous coughing.

Outcomes

Radioactive tracer clearance (measured every 30 min for 3 hours on each occasion).

Sputum weight.

Penetration index (median and range).

Retention at 24 hours (median and range).

Number of huffs performed during treatment sessions (median and range).

Number of cough maneuvers (median and range).

(only radioactive tracer clearance, sputum weight and FEV1 reported outcomes in this review).

Notes

Measurements 30 minutes, 1 hour and 24 hours after intervention.

Study approved by local ethical committee of Copenhagen.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Paper states random order of the interventions, but no details of randomisation method given

Allocation concealment (selection bias)

Unclear risk

Not discussed

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Described as single‐blind, since participants and care‐givers could not be blinded due to type of intervention, assume that outcome assessors were blinded but no detail of how this was achieved.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

No mention of any dropouts, however data for all 10 patients present.

Selective reporting (reporting bias)

Low risk

Protocol not available for comparison, but data on expected outcomes reported.Immediate measurement after intervention.

Other bias

Unclear risk

Funding source reported.

Unknown whether patients naive to all interventions prior to study.

Pfleger 1992

Methods

Cross‐over study, interventions given in random order.

Participants

14 patients with CF (5 males; 9 females).
Mean (range) age 14 (9.8 ‐ 22.4) years.

Mean (SD) FEV1% predicted 53% (21%).

Interventions

PEP breathing.
AD.
PEP followed by AD.
AD followed by PEP.
Control, spontaneous coughing.

Outcomes

Pulmonary function tests (FVC, FEV1, RV/TLC, Raw); weight of expectorated mucus.

Notes

Measurements during and immediately after intervention.

Patients trained in interventions 6 months before commencement of the study.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Paper states random order of the interventions, but no details of randomisation method given.

Allocation concealment (selection bias)

Unclear risk

Not discussed.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Interventions did not allow participants or clinicians to be blinded. Assessor for sputum weight blinded, but not discussed whether assessment of other outcomes blinded.

Incomplete outcome data (attrition bias)
All outcomes

Low risk

Abstract and paper state that 15 participants were randomly selected from local clinic, but data from 14 only as 1 developed symptoms of acute respiratory viral infection during study and was excluded.

Selective reporting (reporting bias)

Low risk

Protocol not available for comparison, but data on expected outcomes reported. Immediate measurement after intervention.

Other bias

Low risk

Funding source not reported, however potential sources not thought to introduce a significant risk of introducing bias.

Rossman 1982

Methods

Cross‐over study, interventions given in random order.

Participants

6 patients with CF (all male).

Mean (SD) age: 22.8 (5.6) years.

Range FEV1% predicted 12 to 77.7%.

Interventions

Postural drainage.
Postural drainage, mechanical percussion.
Regimented coughing.
Chest physiotherapy, breathing exercises, vibrations, manual percussion, postural drainage.
Control, spontaneous coughing.

Outcomes

Radioactive tracer clearance; sputum weight.

Notes

Measurements during and up to 2 hours after intervention.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Paper states random order of the interventions, but no details of randomisation method given.

Allocation concealment (selection bias)

Unclear risk

Not discussed.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Interventions did not allow participants or clinicians to be blinded, not discussed whether outcome assessors were blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

No mention of any dropouts but data appears complete.

Selective reporting (reporting bias)

Low risk

Protocol not available for comparison, but data on expected outcomes reported. Immediate measurement after intervention.

Other bias

Unclear risk

Funding source not reported, however potential sources not thought to introduce a significant risk of introducing bias.

Unknown whether patients naive to all interventions prior to study.

van der Schans 1991

Methods

Cross‐over study, interventions given in random order.

Participants

8 patients with CF, gender split not reported.
Mean (SD) age: 16 (3) years.

Mean (SD) FEV1% predicted 70% (24%).

Interventions

PEP breathing with a resistance of 5 cmH2O followed by 5 minutes of coughing.

PEP breathing with a resistance of 15 cmH2O followed by 5 minutes of coughing.
Control followed by 5 minutes of coughing.

Outcomes

Radioactive tracer clearance; TLC, FRC.

Notes

Measurements during intervention.

Risk of bias

Bias

Authors' judgement

Support for judgement

Random sequence generation (selection bias)

Unclear risk

Paper states random order of the interventions, but no details of randomisation method given.

Allocation concealment (selection bias)

Unclear risk

Not discussed.

Blinding (performance bias and detection bias)
All outcomes

Unclear risk

Interventions did not allow participants or clinicians to be blinded, not discussed whether outcome assessors were blinded.

Incomplete outcome data (attrition bias)
All outcomes

Unclear risk

No dropouts mentioned.

Selective reporting (reporting bias)

Low risk

Protocol not available for comparison, but data on expected outcomes reported. Immediate measurement after intervention.

Other bias

Unclear risk

Funding source not reported. however potential sources not thought to introduce a significant risk of introducing bias.

Unknown whether patients naive to all interventions prior to study.

AD: autogenic drainage;
BP: blood pressure
CF: cystic fibrosis
FEF25‐75%: forced expiratory flow 25‐75%
FET: forced expiration technique
FEV1: forced expiratory volume at one second
FRC: functional residual capacity
FVC: forced vital capacity
HAT: hydroacoustic therapy
HR: heart rate
PEP: positive expiratory pressure breathing
RR: respiratory rate
RV: residual volume
SD: standard deviation
SpO2: blood oxygen saturation
TLC: total lung capacity

Characteristics of excluded studies [ordered by study ID]

Study

Reason for exclusion

App 1998

No control group without chest physiotherapy.

Aquino 2012

No control group without chest physiotherapy.

Arens 1994

No control group without chest physiotherapy.

Bain 1988

No control group without chest physiotherapy.

Baldwin 1994

No control group without chest physiotherapy.

Balestri 2004

No control group without chest physiotherapy.

Baran 1977

No control group without chest physiotherapy

Battistini 2001

No control group without chest physiotherapy.

Bauer 1994

No control group without chest physiotherapy.

Bilton 1992

No control group without chest physiotherapy.

Blomquist 1986

No control group without chest physiotherapy.

Borka 2012

No control group without chest physiotherapy.

Braggion 1996

No control group without chest physiotherapy.

Button 1997

No control group without chest physiotherapy.

Castile 1998

No control group without chest physiotherapy.

Castle 1994

No control group without chest physiotherapy.

Cegla 1993

No control group without chest physiotherapy.

Cerny 1989

No control group without chest physiotherapy.

Chatham 1998

No physiotherapy to improve mucus clearance.

Chatham 2004

No control group without chest physiotherapy.

Cochrane 1977

Mixed group of participants (cystic fibrosis, chronic bronchitis, and bronchiectasis).

Costantini 1998

No control group without chest physiotherapy.

Darbee 1990

No control group without chest physiotherapy.

Darbee 2005

No control group without chest physiotherapy.

Davidson 1988

No control group without chest physiotherapy.

Davidson 1992

No control group without chest physiotherapy.

Davidson 1998

No control group without chest physiotherapy.

Davies 2012

No control group without chest physiotherapy.

de Boeck 1984

No control group without chest physiotherapy.

Delk 1994

No physiotherapy to improve mucus clearance.

Desmond 1983

No control group without chest physiotherapy.

Dosman 2003

No control group without chest physiotherapy.

Dunn 2013

No control group without chest physiotherapy.

Elkins 2000

No control group without chest physiotherapy.

Fainardi 2011

No control group without chest physiotherapy.

Falk 1984

No control group without chest physiotherapy.

Falk 1988

No control group without chest physiotherapy.

Fauroux 1999

No chest physiotherapy (airway clearance technique) studied.

Gaskin 1998

No control group without chest physiotherapy.

Gayer 1988

No chest physiotherapy (airway clearance technique) studied.

Giles 1995

No control group without chest physiotherapy.

Giles 1996

No control group without chest physiotherapy.

Gondor 1999

No control group without chest physiotherapy.

Gotz 1995

No control group without chest physiotherapy.

Grasso 2000

No control group without chest physiotherapy.

Grzincich 2008

No control group without chest physiotherapy.

Gursli 2013

No control group without chest physiotherapy.

Hare 2002

No control group without chest physiotherapy.

Hartsell 1978

No control group without chest physiotherapy.

Hofmeyr 1986

No control group without chest physiotherapy.

Holland 2003

No control group without chest physiotherapy.

Homnick 1995

No control group without chest physiotherapy.

Homnick 1998

No control group without chest physiotherapy.

Jacobs 1981

No control group without chest physiotherapy.

Keller 2001

No control group without chest physiotherapy.

Kerrebijn 1982

No control group without chest physiotherapy.

Klig 1989

No control group without chest physiotherapy.

Kluft 1996

No control group without chest physiotherapy.

Kofler 1994

No control group without chest physiotherapy.

Kofler 1998

No control group without chest physiotherapy.

Konstan 1994

No control group without chest physiotherapy.

Kraig 1995

No control group without chest physiotherapy.

Lagerkvist 2006

No control group without chest physiotherapy.

Langenderfer 1998

Not a clinical trial.

Lannefors 1992

No control group without chest physiotherapy.

Lindemann 1992

No control group without chest physiotherapy.

Lorin 1971

No control group without chest physiotherapy.

Lyons 1992

No control group without chest physiotherapy.

Maayan 1989

No control group without chest physiotherapy.

Majaesic 1996

No control group without chest physiotherapy.

Marks 1999

No control group without chest physiotherapy.

Maxwell 1979

No control group without chest physiotherapy.

McCarren 2006

No control group without chest physiotherapy.

McDonnell 1986

No control group without chest physiotherapy.

McIlwaine 1997

No control group without chest physiotherapy.

McIlwaine 2010

No control group without chest physiotherapy.

McIlwaine 2012

no control group without chest physiotherapy.

Miller 1995

No control group without chest physiotherapy.

Milne 2004

No control group without chest physiotherapy.

Morris 1982

No control group without chest physiotherapy.

Mulholland 1994

No control group without chest physiotherapy.

Murphy 1983

No control group without chest physiotherapy.

Murphy 1988

No outcome measures that were the primary purpose of this review were used.

Natale 1994

No control group without chest physiotherapy.

Newhouse 1998

No control group without chest physiotherapy.

Oberwaldner 1986

No control group without chest physiotherapy.

Oberwaldner 1991

No control group without chest physiotherapy.

Orlik 2000

No control group without chest physiotherapy.

Orlik 2000a

No control group without chest physiotherapy.

Orlik 2001

No control group without chest physiotherapy.

Osman 2010

No control group without chest physiotherapy.

Padman 1999

No control group without chest physiotherapy.

Parker 1984

Mixed group of participants: 4 with cystic fibrosis, 5 with bronchiectasis, 1 with asthma.

Parreira 2008

No control group without chest physiotherapy.

Parsons 1995

No control group without chest physiotherapy.

Patel 2013

No control group without chest physiotherapy.

Phillips 1998

No control group without chest physiotherapy.

Phillips 2004

No control group without chest physiotherapy.

Pike 1999

No control group without chest physiotherapy.

Placidi 2006

No control group without chest physiotherapy.

Pollard 2000

No control group without chest physiotherapy.

Prasad 2005

no control group without chest physiotherapy

Pryor 1979a

No control group without chest physiotherapy.

Pryor 1979b

No control group without chest physiotherapy.

Pryor 1981

No control group without chest physiotherapy.

Pryor 1990

No control group without chest physiotherapy.

Pryor 1994

No control group without chest physiotherapy.

Pryor 2010

No control group without chest physiotherapy.

Reisman 1988

No control group without chest physiotherapy.

Reix 2009

No control group without chest physiotherapy.

Rodriguez 2013

No control group without chest physiotherapy.

Roos 1987

No control group without chest physiotherapy.

Salh 1989

No control group without chest physiotherapy.

Samuelson 1994

No control group without chest physiotherapy.

Sanchez 1999

No control group without chest physiotherapy.

Scherer 1998

No control group without chest physiotherapy.

Sokol 2012

No control group without chest physiotherapy, primary intervention outside scope of this review.

Sontag 2010

No control group without chest physiotherapy.

Steen 1991

No control group without chest physiotherapy.

Steven 1992

No control group without chest physiotherapy.

Stites 2006

Intervention not thought to improve mucus clearance.

Sutton 1985

Mixed group of participants: 5 with bronchiectasis, 2 with chronic bronchitis and only 1 with cystic fibrosis.

Tannenbaum 2001

Study in participants during intra‐operative period under anaesthesia and mechanical ventilation.

Tecklin 1976

No control group without chest physiotherapy.

Thomas 1995

Not a clinical trial, a review.

Tonnesen 1982

No control group without chest physiotherapy.

Toral 1997

No control group without chest physiotherapy.

Tugay 2000

No control group without chest physiotherapy.

Tyrrell 1986

No control group without chest physiotherapy.

van Asperen 1987

No control group without chest physiotherapy.

Van Ginderdeuren 2000

No control group without chest physiotherapy.

Van Ginderdeuren 2008

no control group without chest physiotherapy.

van Hengstum 1987

No cystic fibrosis participants.

van Hengstum 1988

No control group without chest physiotherapy.

van Winden 1998

No control group without chest physiotherapy.

Vanlaethem 2008

No control group without physiotherapy.

Verboon 1986

No control group without chest physiotherapy.

Warwick 1990

No control group without chest physiotherapy.

Warwick 1991

No control group without chest physiotherapy.

Warwick 2004

No control group without chest physiotherapy.

Webber 1985

No control group without chest physiotherapy.

West 2010

No control group without chest physiotherapy.

Wheatley 2013

No control group without chest physiotherapy.

White 1997

No control group without chest physiotherapy.

Wilson 1995

No control group without chest physiotherapy.

Wong 1999

No control group without chest physiotherapy.

Wordsworth 1996

No chest physiotherapy.

Zapletal 1983

No control group without chest physiotherapy.

Znotina 2000

No control group without chest physiotherapy.