In a short-term controlled study of 20 patients with cystic fibrosis and chronic sputum production, chest physiotherapy resulted in a significantly improved peak flow over a whole day, with no significant difference in other forced expiratory flows, when compared to a control day. This suggests that physiotherapy may be effective in enhancing clearance of sputum from central large airways, but it has little obvious effect on more peripheral airways. A bronchodilator given before physiotherapy had no added effects. It is important that we examine ways of improving physiotherapy to aid clearance of secretions from the more peripheral airways.
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