The investigators aim to compare a single bout of moderately intense cycling exercise incorporating Flutter® breathing maneuvers with a single bout of moderately intense cycling exercise alone on sputum viscoelasticity (primary endpoint) and the diffusion capacity of the lungs in adult patients with cystic fibrosis. The investigators further aim to analyze the short-term variability of resting diffusion capacity of carbon monoxide (DLCO) and nitric oxide (DLNO) in patients with cystic fibrosis.
Regular airway clearance is an integral component of cystic fibrosis care and of critical importance to lung health. Exercise and standardized chest physiotherapy are accepted airway clearance techniques in cystic fibrosis. Different airway clearance techniques are available, but there is no evidence that one technique or a combination is superior. Oscillatory positive expiratory pressure with the Flutter® is a widely used airway clearance technique in the European countries and has been shown to favourably alter sputum viscoelasticity in cystic fibrosis. This randomized crossover study is designed to assess the acute effects of combined cycling exercise and Flutter® therapy on sputum viscoelasticity (primary outcome measure) and gas diffusion in adults with cystic fibrosis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
16
Acute exercise with Flutter® breathing therapy.
Acute exercise without Flutter® breathing therapy.
University of Zurich
Zurich, Canton of Zurich, Switzerland
University Hospital Zurich
Zurich, Canton of Zurich, Switzerland
ETH Zurich
Zurich, Canton of Zurich, Switzerland
Change in sputum viscoelasticity (G*) over a broad frequency range (1-100 rad.s-1)
Sputum viscoelasticity measured by stress/strain controlled rheometer (Anton Paar, MCR 301/MCR 501).
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in shear viscosity (η)
Shear viscosity measured by stress/strain controlled rheometer (Anton Paar, MCR 301/MCR 501).
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in sputum spinnability (mm)
Measured with a Capillary Breakup Extensional Rheometer (CaBER).
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in sputum solids content (%)
Sputum weight of a 50 μL aliquot before and after lyophilization to dryness using a freeze dryer.
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in lung diffusion capacity for nitric oxide (DLNO)
Single-breath measurements with MasterScreenTM PFT system
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in lung diffusion capacity for carbon monoxide (DLCO)
Single-breath measurements with MasterScreenTM PFT system
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in DLNO/DLCO ratio
Single-breath measurements with MasterScreenTM PFT system
Time frame: Baseline - immediately post exercise - 45min post exercise
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Change in alveolar volume
Single-breath measurements with MasterScreenTM PFT system
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in pulmonary capillary blood volume
Single-breath measurements with MasterScreenTM PFT system
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in pulmonary membrane diffusion capacity
Single-breath measurements with MasterScreenTM PFT system
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in ease of sputum expectoration (cm)
Assessed by a visual analogue scale (0-10)
Time frame: Baseline - immediately post exercise - 45min post exercise
Change in oxygen saturation (%)
Measured by pulse oximetry.
Time frame: Baseline - immediately post exercise - 45min post exercise