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The Effect of a Comprehensive, Intensive Inpatient Treatment Program on Lung Function and Exercise Capacity in Patients With Cystic Fibrosis

JA Alison, MSc (Lond), Dip Phty (Syd), is Research Assistant, Department of Thoracic Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia, and Senior Lecturer in Cardio-Pulmonary Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
PM Donnelly, Dip Med Tech, is Professional Officer, University of Sydney.
M Lennon, BSc, Grad Dip Phty, is Senior Cardio-Pulmonary Physiotherapist, Department of Physiotherapy, Royal Prince Alfred Hospital.
S Parker, BAppSc (Phty), is Cardio-Pulmonary Physiotherapist, Department of Physiotherapy, Royal Prince Alfred Hospital.
P Torzillo, MB, BS, FRACP, is Visiting Respiratory Physician and Intensive Care Specialist, Department of Thoracic Medicine, Royal Prince Alfred Hospital.
C Mellis, MB, BS, FRACP, is Senior Staff Respiratory Physician, Department of Respiratory Medicine, Royal Alexandra Hospital for Children, Sydney, New South Wales, Australia.
PTP Bye, PhD, MB, BS, FRACP, is Clinical Associate Professor, Department of Thoracic Medicine, and Director of Cystic Fibrosis Service, Royal Prince Alfred Hospital.

Background and Purpose. The purpose of this investgation was to measure the effects of a 10- to 14-day comprehensive, intensive hospital treatment program on peak exercise capacity, endurance capacity, respiratory function, weight change, and maximum inspiratory and expiratory mouth pressures in patients with cystic fibrosis with a pulmonary exacerbation. Subjects. Fourteen young adults with cystic fibrosis admitted to a hospital for an exacerbation of their pulmonary disease were studied. Methods. Subjects performed pulmonary function tests, inspiratory and expiratory mouth pressure tests, and stationary bicycle exercise tests at admission and discharge. Comprehensive therapy provided during the hospital admission consisted of intravenous antibiotics, physical therapy, high-calorie diet, and daily medical review. Results. The patients showed improvements in forced expiratory volume in 1 second (46%–55% of predicted values) and forced vital capacity (62%–68% of predicted values). Maximum inspiratory and expiratory mouth pressures also improved (118%–131% and 78%–92% of predicted values, respectively). There was a mean weight gain of 2 kg. Maximum work capacity on a bicycle ergometer improved from a mean of 45% to 52% of predicted values. The most impressive result was the marked increase in exercise endurance time from a mean of 9.5 minutes on admission to 16.6 minutes at discharge. Conclusion and Discussion. This study indicates that young adults with cystic fibrosis and an exacerbation of their pulmonary disease obtain measurable benefits from a comprehensive, intensive treatment program, particularly improvement in their capacity for endurance exercise.

Key Words: Cystic fibrosis • Exercise therapy • Hospital therapy • Lung function • Physical therapy

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