Airway clearance and exercise for cystic fibrosis

The aim of airway clearance for cystic fibrosis (CF) is to clear secretions from the bronchi; this relieves airway obstruction and prevents infection, which would otherwise lead to progressive lung injury.

Airway clearance methods include physical techniques and drug treatment.

An experienced respiratory physiotherapist with expertise in CF should develop an individualised airway clearance program for the patient. Airway clearance using forced expiration techniques is the most successful method of clearing bronchial secretions, and teaching this should be the basis of any airway clearance program for patients with CF. This is particularly relevant in young children.

Drug treatment for airway clearance can include inhaled bronchodilators and mucolytics.

Daily airway clearance is recommended for patients with CF. In general, airway clearance is performed once daily in those with mild lung disease when asymptomatic; airway clearance may be increased to twice daily (or more frequently as appropriate and if the patient is able) during an exacerbation.

An active lifestyle is encouraged; airway clearance combined with exercise results in a greater increase in lung function compared with airway clearance alone. Exercise should not replace an individualised airway clearance program in patients with CF.

For more information on different airway clearance techniques, see the Cystic Fibrosis Australia website. The Bronchiectasis Toolbox website also provides information and videos on airway clearance techniques.