Abstract
It has been routine management to prescribe daily physiotherapy (PT) for all newly diagnosed patients with Cystic Fibrosis (CF). Newborn screening was introduced in the state of Victoria in 1990, resulting in the commencement of daily PT from around 2 months regardless of symptoms. Recent reports suggest that infants with CF may have a ligher incidence of gastro-oesophageal reflux (GOR) than normal. >ostural drainage (PD) may increase GOR in infants with CF.
Aim: to measure the acute effects on oesophageal pH of standard PT with head down tilt (SPT), versus modified PT without head down tilt (MPT), of 4 widely used PD positions in infants with CF.
Method: 11 infants (5 female, 6 male) with CF underwent 30 hour oesophageal pH monitoring during which SPT and MPT were carried out on two consecutive days with reversal of order. This information was analysed by computer and compared to the corresponding periods of time without PT (No-PT).
Results: There was a significant increase in number of reflux episodes (NRE) and fraction of time (FRT) during SPT compared to No-PT. (NRE /hour: No-PT 1.13±0.63/hour versus SPT 2.74±1.77, p<0.01) (FRT: No-PT 7.65±5.94% versus SPT 13.94±11.54%, p<0.05). MPT was not associated with d significant increase in NRE or FRT.
Conclusion: SPT increases acid reflux in some infants with CF, but further longitudinal research to ascertain effects on lung function is required. The effectiveness of MPT on muco-ciliary clearance needs to be evaluated.
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Button, B., Heine, R., Catto-Smith, A. et al. 41 ACUTE EFFECTS OF POSTURAL DRAINAGE ON GASTRO-OESOPHAGEAL REFLUX IN INFANTS WITH CYSTIC FIBROSIS. Pediatr Res 36, 9 (1994). https://doi.org/10.1203/00006450-199407000-00041
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DOI: https://doi.org/10.1203/00006450-199407000-00041