Supervised outpatient exercise and physical therapy are associated with improvements in quality of life and exercise tolerance, a reduction in IV antibiotic days, and a trend toward reducing lung function decline in children with cystic fibrosis (CF), say authors of an article published in Pediatric Pulmonology. The cost of IV antibiotics was reduced by $104,000 in 2010 when compared with 2009. Such cost benefit may have implications for workforce planning and service provision, they add.
Twelve children (6 girls) with CF aged 10 years or older (mean age 13.3 years) who had received 4 or more courses of IV antibiotics in 2009 were enrolled in the study. The children participated in supervised exercise and physical therapy once every 2 weeks throughout 2010. In addition, they were expected to exercise 3 times weekly. If unwell, the children completed additional physical therapy sessions to usual chest physical therapy. Assessments of exercise capacity using the Modified Shuttle Test (MST) and quality of life (QOL; CFQ-UK) were recorded at baseline and after 1 year. Regular spirometry was performed before and throughout the study. Data were collected on IV antibiotic days.
A significant reduction in IV antibiotic days from 60 days in 2009 to 50 in 2010 was noted, along with improved MST distance (735 vs 943) and level attained (9.4 vs 11.1).
Significant improvements in CFQ-UK scores for physical (59 vs 83), emotional (63 vs 84), treatment (41 vs 61), and respiratory (54 vs 76) domains were noted. The mean rate of change of FEV(1) was -4 (-18, +10)% in 2009, but was +6 (-2, +13)% in 2010, although this did not reach statistical significance.