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Original Research: CYSTIC FIBROSIS |

Effects of Exercise on Respiratory Flow and Sputum Properties in Patients With Cystic Fibrosis

Tiffany J. Dwyer, PhD; Jennifer A. Alison, Dip Physio, PhD; Zoe J. McKeough, PhD; Evangelia Daviskas, MBiomedE, PhD; Peter T. P. Bye, MBBS, PhD, FCCP
Author and Funding Information

From the Discipline of Physiotherapy (Drs Dwyer, Alison, and McKeough), Faculty of Health Sciences, University of Sydney; Department of Respiratory Medicine (Drs Dwyer, Alison, Daviskas, and Bye), Royal Prince Alfred Hospital; and Central Clinical School (Drs Dwyer and Bye), Sydney Medical School, University of Sydney, Sydney, NSW, Australia.

Correspondence to: Tiffany J. Dwyer, PhD, Department of Respiratory Medicine, Level 11 W, Royal Prince Alfred Hospital, Missenden Rd, Camperdown, NSW 2050, Australia; e-mail: tiffany.dwyer@sydney.edu.au


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Funding/Support: Dr Dwyer was supported by an Australian Postgraduate Award scholarship from the University of Sydney. No other funding was received for this work.


© 2011 American College of Chest Physicians


Chest. 2011;139(4):870-877. doi:10.1378/chest.10-1158
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Background:  The physiologic mechanisms by which exercise may clear secretions in subjects with cystic fibrosis (CF) are unknown. The purpose of this study was to compare ventilation, respiratory flow, and sputum properties following treadmill and cycle exercise with resting breathing (referred to as “control”).

Methods:  In 14 adult subjects with CF, ventilation and respiratory flow were measured during 20 min of resting breathing, treadmill exercise, and cycle exercise in a 3-day crossover study. Treadmill and cycle exercise were performed at the work rate equivalent to 60% of the subject’s peak oxygen uptake. Ease of expectoration and sputum properties (solids content and mechanical impedance) were measured before and immediately after the interventions and after 20-min recovery.

Results:  Ease of expectoration improved following exercise. Ventilation and respiratory flow were significantly higher during treadmill and cycle exercise compared with control. Sputum solids content did not change following treadmill or cycle exercise. There was a significantly greater decrease in sputum mechanical impedance following treadmill exercise compared with control, but no significant decrease in sputum mechanical impedance following cycle exercise compared with control.

Conclusions:  The improvement in ease of expectoration following exercise may have been due to the higher ventilation and respiratory flow. The reductions in sputum mechanical impedance with treadmill exercise may have been due to the trunk oscillations associated with walking.

Trial Registry:  Australian and New Zealand Clinical Trials Registry; No. 12605000422628; URL: www.anzctr.org.au

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