CFDB - Cystic Fibrosis DataBase

primary studies published RCT

Effects of exercise and airway clearance (PEP) on mucus clearance in cystic fibrosis: a randomised cross-over trial.

Study design (if review, criteria of inclusion for studies)

Randomised, controlled, cross-over trial.


Fourteen adults with mild to severe CF lung disease (FEV1 31-113% predicted)


Treadmill exercise vs resting breathing and Positive Expiratory Pressure (PEP) therapy

Outcome measures

Mucus clearance was measured using the radioaerosol technique and gamma camera imaging.

Main results

Treadmill exercise improved whole lung mucus clearance compared to resting breathing (mean difference 3%, 95% CI 2-4), however exercise alone was less effective than PEP therapy (mean difference -7%, 95% CI -6- -8). When comparing treadmill exercise to PEP therapy, there were no significant differences in mucus clearance from the intermediate and peripheral lung regions, but significantly less clearance from the central lung region (likely reflecting the huffing and coughing that was only in PEP therapy).

Keywords: Aerobic training; Airway clearance technique; Chest physiotherapy; exercise; non pharmacological intervention - devices OR physiotherapy; Positive-Pressure Respiration- PEP- pep mask; Respiratory Tract Diseases; strength training; training;