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Brenda M Button - One of the best experts on this subject based on the ideXlab platform.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Background: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. Aims: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. Methods: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT–SPT; day 2: SPT–MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30° head-down tilt). Results: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. Conclusions: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood-education and Practice Edition, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    BACKGROUND: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. AIMS: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. METHODS: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT-SPT; day 2: SPT-MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30 degrees head-down tilt). RESULTS: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. CONCLUSIONS: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy in infants with cystic fibrosis to tip or not a five year study
    Pediatric Pulmonology, 2003
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky, Michael Ditchfield, Ian Story
    Abstract:

    There is controversy about the need for Postural Drainage physiotherapy in asymptomatic infants with cystic fibrosis (CF). We aimed to compare the effectiveness of standard Postural Drainage chest physiotherapy (SPT) with a modified physiotherapy regimen without head-down tilt (MPT) in young infants with CF. Twenty newly diagnosed infants with CF (mean age, 2.1 months; range, 1–4) were randomized to SPT or MPT. Parents kept a detailed symptom and treatment diary for the following 12 months. Serial chest radiographs, taken at diagnosis, 12 months, 2½ years, and 5 years after diagnosis, were assessed using the Brasfield score. Pulmonary function tests were compared between groups after 5 years. Of the 20 infants, 16 (80%) completed the review at 12 months, and 14 (70%) at 2½ and 5 years. Patients receiving SPT had more days with upper respiratory tract symptoms than those on MPT (70 ± 32.8 vs. 37 ± 24.9 days; P = 0.04) and required longer courses of antibiotics (23 ± 28.5 vs. 14 ± 11.2 days; P = 0.05). Chest x-ray scores were similar at diagnosis but were worse at 2½ years for those receiving SPT (P = 0.03). Forced vital capacity and forced expired volume in 1 sec (FEV1) at 5–6 years was lower for SPT than for MPT (P < 0.05). In conclusion, MPT was associated with fewer respiratory complications than SPT in infants with CF. Pediatr Pulmonol. 2003; 35:208–213. © 2003 Wiley-Liss, Inc.

  • Postural Drainage in cystic fibrosis is there a link with gastro oesophageal reflux
    Journal of Paediatrics and Child Health, 1998
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan
    Abstract:

    Objectives: To determine the clinical effects of a change from Postural Drainage (PD) to positive expiratory pressure chest physiotherapy (PEP) in children with cystic fibrosis (CF) and symptoms of gastro-oesophageal reflux (GOR). To measure the effects of PD on GOR in children with CF. Methods: Study 1: Six adolescents with CF and symptoms of GOR during PD were changed to upright PEP physiotherapy. The effects on lung function, reflux symptom scores and annual hospital days were measured. Study 2: Twenty-four children with CF (mean age 11 years) and symptoms suggestive of GOR underwent 24-h pH monitoring, including periods of chest physiotherapy. Results: Study 1: All six patients reported a reduction in reflux symptoms during PEP therapy (P<0.001). Lung function parameters improved during the first 6 months of PEP (P<0.001). This improvement was sustained for a further 18 months. Annual hospital days decreased significantly (P<0.0005). Study 2: Nine of 24 patients (37.5%) had pathological GOR. Reflux episodes were significantly increased during PD (P<0.0001), as was fractional reflux time (P<0.01). Conclusions: Upright PEP physiotherapy may be more appropriate than PD in selected patients with CF and symptomatic GOR. The role of GOR as a cofactor in the progression of pulmonary disease in CF needs further evaluation.

  • Postural Drainage and gastro oesophageal reflux in infants with cystic fibrosis
    Archives of Disease in Childhood, 1997
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Gastro-oesophageal reflux is increased in cystic fibrosis and it is possible that Postural Drainage techniques may exacerbate reflux, potentially resulting in aspiration and further impairment of pulmonary function. AIM To evaluate the effects of physiotherapy with head down tilt (standard physiotherapy, SPT) on gastro-oesophageal reflux and to compare this with physiotherapy without head down tilt (modified physiotherapy, MPT). METHOD Twenty (mean age 2.1 months) infants with cystic fibrosis underwent 30 hour oesophageal pH monitoring during which SPT and MPT were carried out for two sessions each on consecutive days. RESULTS The number of reflux episodes per hour, but not their duration, was significantly increased during SPT compared with MPT (SPT 2.5 (0.4) v MPT 1.6 (0.3), p = 0.007) and to background (1.1 (0.)1, p = 0.0005). Fractional reflux time was also increased during SPT (11.7 (2.6)%) compared with background (6.9 (1.3)%, p = 0.03) but not compared with MPT (10.7 (2.7)%). There was no significant difference between MPT and background for number of reflux episodes, their duration, or fractional reflux time. CONCLUSION SPT, but not MPT, was associated with a significant increase in gastro-oesophageal reflux in infants with cystic fibrosis.

Anthony Olinsky - One of the best experts on this subject based on the ideXlab platform.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Background: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. Aims: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. Methods: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT–SPT; day 2: SPT–MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30° head-down tilt). Results: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. Conclusions: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood-education and Practice Edition, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    BACKGROUND: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. AIMS: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. METHODS: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT-SPT; day 2: SPT-MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30 degrees head-down tilt). RESULTS: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. CONCLUSIONS: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy in infants with cystic fibrosis to tip or not a five year study
    Pediatric Pulmonology, 2003
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky, Michael Ditchfield, Ian Story
    Abstract:

    There is controversy about the need for Postural Drainage physiotherapy in asymptomatic infants with cystic fibrosis (CF). We aimed to compare the effectiveness of standard Postural Drainage chest physiotherapy (SPT) with a modified physiotherapy regimen without head-down tilt (MPT) in young infants with CF. Twenty newly diagnosed infants with CF (mean age, 2.1 months; range, 1–4) were randomized to SPT or MPT. Parents kept a detailed symptom and treatment diary for the following 12 months. Serial chest radiographs, taken at diagnosis, 12 months, 2½ years, and 5 years after diagnosis, were assessed using the Brasfield score. Pulmonary function tests were compared between groups after 5 years. Of the 20 infants, 16 (80%) completed the review at 12 months, and 14 (70%) at 2½ and 5 years. Patients receiving SPT had more days with upper respiratory tract symptoms than those on MPT (70 ± 32.8 vs. 37 ± 24.9 days; P = 0.04) and required longer courses of antibiotics (23 ± 28.5 vs. 14 ± 11.2 days; P = 0.05). Chest x-ray scores were similar at diagnosis but were worse at 2½ years for those receiving SPT (P = 0.03). Forced vital capacity and forced expired volume in 1 sec (FEV1) at 5–6 years was lower for SPT than for MPT (P < 0.05). In conclusion, MPT was associated with fewer respiratory complications than SPT in infants with CF. Pediatr Pulmonol. 2003; 35:208–213. © 2003 Wiley-Liss, Inc.

  • Postural Drainage and gastro oesophageal reflux in infants with cystic fibrosis
    Archives of Disease in Childhood, 1997
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Gastro-oesophageal reflux is increased in cystic fibrosis and it is possible that Postural Drainage techniques may exacerbate reflux, potentially resulting in aspiration and further impairment of pulmonary function. AIM To evaluate the effects of physiotherapy with head down tilt (standard physiotherapy, SPT) on gastro-oesophageal reflux and to compare this with physiotherapy without head down tilt (modified physiotherapy, MPT). METHOD Twenty (mean age 2.1 months) infants with cystic fibrosis underwent 30 hour oesophageal pH monitoring during which SPT and MPT were carried out for two sessions each on consecutive days. RESULTS The number of reflux episodes per hour, but not their duration, was significantly increased during SPT compared with MPT (SPT 2.5 (0.4) v MPT 1.6 (0.3), p = 0.007) and to background (1.1 (0.)1, p = 0.0005). Fractional reflux time was also increased during SPT (11.7 (2.6)%) compared with background (6.9 (1.3)%, p = 0.03) but not compared with MPT (10.7 (2.7)%). There was no significant difference between MPT and background for number of reflux episodes, their duration, or fractional reflux time. CONCLUSION SPT, but not MPT, was associated with a significant increase in gastro-oesophageal reflux in infants with cystic fibrosis.

Ralf G Heine - One of the best experts on this subject based on the ideXlab platform.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Background: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. Aims: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. Methods: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT–SPT; day 2: SPT–MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30° head-down tilt). Results: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. Conclusions: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood-education and Practice Edition, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    BACKGROUND: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. AIMS: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. METHODS: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT-SPT; day 2: SPT-MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30 degrees head-down tilt). RESULTS: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. CONCLUSIONS: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy in infants with cystic fibrosis to tip or not a five year study
    Pediatric Pulmonology, 2003
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky, Michael Ditchfield, Ian Story
    Abstract:

    There is controversy about the need for Postural Drainage physiotherapy in asymptomatic infants with cystic fibrosis (CF). We aimed to compare the effectiveness of standard Postural Drainage chest physiotherapy (SPT) with a modified physiotherapy regimen without head-down tilt (MPT) in young infants with CF. Twenty newly diagnosed infants with CF (mean age, 2.1 months; range, 1–4) were randomized to SPT or MPT. Parents kept a detailed symptom and treatment diary for the following 12 months. Serial chest radiographs, taken at diagnosis, 12 months, 2½ years, and 5 years after diagnosis, were assessed using the Brasfield score. Pulmonary function tests were compared between groups after 5 years. Of the 20 infants, 16 (80%) completed the review at 12 months, and 14 (70%) at 2½ and 5 years. Patients receiving SPT had more days with upper respiratory tract symptoms than those on MPT (70 ± 32.8 vs. 37 ± 24.9 days; P = 0.04) and required longer courses of antibiotics (23 ± 28.5 vs. 14 ± 11.2 days; P = 0.05). Chest x-ray scores were similar at diagnosis but were worse at 2½ years for those receiving SPT (P = 0.03). Forced vital capacity and forced expired volume in 1 sec (FEV1) at 5–6 years was lower for SPT than for MPT (P < 0.05). In conclusion, MPT was associated with fewer respiratory complications than SPT in infants with CF. Pediatr Pulmonol. 2003; 35:208–213. © 2003 Wiley-Liss, Inc.

  • Postural Drainage in cystic fibrosis is there a link with gastro oesophageal reflux
    Journal of Paediatrics and Child Health, 1998
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan
    Abstract:

    Objectives: To determine the clinical effects of a change from Postural Drainage (PD) to positive expiratory pressure chest physiotherapy (PEP) in children with cystic fibrosis (CF) and symptoms of gastro-oesophageal reflux (GOR). To measure the effects of PD on GOR in children with CF. Methods: Study 1: Six adolescents with CF and symptoms of GOR during PD were changed to upright PEP physiotherapy. The effects on lung function, reflux symptom scores and annual hospital days were measured. Study 2: Twenty-four children with CF (mean age 11 years) and symptoms suggestive of GOR underwent 24-h pH monitoring, including periods of chest physiotherapy. Results: Study 1: All six patients reported a reduction in reflux symptoms during PEP therapy (P<0.001). Lung function parameters improved during the first 6 months of PEP (P<0.001). This improvement was sustained for a further 18 months. Annual hospital days decreased significantly (P<0.0005). Study 2: Nine of 24 patients (37.5%) had pathological GOR. Reflux episodes were significantly increased during PD (P<0.0001), as was fractional reflux time (P<0.01). Conclusions: Upright PEP physiotherapy may be more appropriate than PD in selected patients with CF and symptomatic GOR. The role of GOR as a cofactor in the progression of pulmonary disease in CF needs further evaluation.

  • Postural Drainage and gastro oesophageal reflux in infants with cystic fibrosis
    Archives of Disease in Childhood, 1997
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Gastro-oesophageal reflux is increased in cystic fibrosis and it is possible that Postural Drainage techniques may exacerbate reflux, potentially resulting in aspiration and further impairment of pulmonary function. AIM To evaluate the effects of physiotherapy with head down tilt (standard physiotherapy, SPT) on gastro-oesophageal reflux and to compare this with physiotherapy without head down tilt (modified physiotherapy, MPT). METHOD Twenty (mean age 2.1 months) infants with cystic fibrosis underwent 30 hour oesophageal pH monitoring during which SPT and MPT were carried out for two sessions each on consecutive days. RESULTS The number of reflux episodes per hour, but not their duration, was significantly increased during SPT compared with MPT (SPT 2.5 (0.4) v MPT 1.6 (0.3), p = 0.007) and to background (1.1 (0.)1, p = 0.0005). Fractional reflux time was also increased during SPT (11.7 (2.6)%) compared with background (6.9 (1.3)%, p = 0.03) but not compared with MPT (10.7 (2.7)%). There was no significant difference between MPT and background for number of reflux episodes, their duration, or fractional reflux time. CONCLUSION SPT, but not MPT, was associated with a significant increase in gastro-oesophageal reflux in infants with cystic fibrosis.

Anthony G Cattosmith - One of the best experts on this subject based on the ideXlab platform.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Background: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. Aims: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. Methods: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT–SPT; day 2: SPT–MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30° head-down tilt). Results: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. Conclusions: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood-education and Practice Edition, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    BACKGROUND: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. AIMS: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. METHODS: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT-SPT; day 2: SPT-MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30 degrees head-down tilt). RESULTS: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. CONCLUSIONS: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy in infants with cystic fibrosis to tip or not a five year study
    Pediatric Pulmonology, 2003
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky, Michael Ditchfield, Ian Story
    Abstract:

    There is controversy about the need for Postural Drainage physiotherapy in asymptomatic infants with cystic fibrosis (CF). We aimed to compare the effectiveness of standard Postural Drainage chest physiotherapy (SPT) with a modified physiotherapy regimen without head-down tilt (MPT) in young infants with CF. Twenty newly diagnosed infants with CF (mean age, 2.1 months; range, 1–4) were randomized to SPT or MPT. Parents kept a detailed symptom and treatment diary for the following 12 months. Serial chest radiographs, taken at diagnosis, 12 months, 2½ years, and 5 years after diagnosis, were assessed using the Brasfield score. Pulmonary function tests were compared between groups after 5 years. Of the 20 infants, 16 (80%) completed the review at 12 months, and 14 (70%) at 2½ and 5 years. Patients receiving SPT had more days with upper respiratory tract symptoms than those on MPT (70 ± 32.8 vs. 37 ± 24.9 days; P = 0.04) and required longer courses of antibiotics (23 ± 28.5 vs. 14 ± 11.2 days; P = 0.05). Chest x-ray scores were similar at diagnosis but were worse at 2½ years for those receiving SPT (P = 0.03). Forced vital capacity and forced expired volume in 1 sec (FEV1) at 5–6 years was lower for SPT than for MPT (P < 0.05). In conclusion, MPT was associated with fewer respiratory complications than SPT in infants with CF. Pediatr Pulmonol. 2003; 35:208–213. © 2003 Wiley-Liss, Inc.

  • Postural Drainage in cystic fibrosis is there a link with gastro oesophageal reflux
    Journal of Paediatrics and Child Health, 1998
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan
    Abstract:

    Objectives: To determine the clinical effects of a change from Postural Drainage (PD) to positive expiratory pressure chest physiotherapy (PEP) in children with cystic fibrosis (CF) and symptoms of gastro-oesophageal reflux (GOR). To measure the effects of PD on GOR in children with CF. Methods: Study 1: Six adolescents with CF and symptoms of GOR during PD were changed to upright PEP physiotherapy. The effects on lung function, reflux symptom scores and annual hospital days were measured. Study 2: Twenty-four children with CF (mean age 11 years) and symptoms suggestive of GOR underwent 24-h pH monitoring, including periods of chest physiotherapy. Results: Study 1: All six patients reported a reduction in reflux symptoms during PEP therapy (P<0.001). Lung function parameters improved during the first 6 months of PEP (P<0.001). This improvement was sustained for a further 18 months. Annual hospital days decreased significantly (P<0.0005). Study 2: Nine of 24 patients (37.5%) had pathological GOR. Reflux episodes were significantly increased during PD (P<0.0001), as was fractional reflux time (P<0.01). Conclusions: Upright PEP physiotherapy may be more appropriate than PD in selected patients with CF and symptomatic GOR. The role of GOR as a cofactor in the progression of pulmonary disease in CF needs further evaluation.

  • Postural Drainage and gastro oesophageal reflux in infants with cystic fibrosis
    Archives of Disease in Childhood, 1997
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Gastro-oesophageal reflux is increased in cystic fibrosis and it is possible that Postural Drainage techniques may exacerbate reflux, potentially resulting in aspiration and further impairment of pulmonary function. AIM To evaluate the effects of physiotherapy with head down tilt (standard physiotherapy, SPT) on gastro-oesophageal reflux and to compare this with physiotherapy without head down tilt (modified physiotherapy, MPT). METHOD Twenty (mean age 2.1 months) infants with cystic fibrosis underwent 30 hour oesophageal pH monitoring during which SPT and MPT were carried out for two sessions each on consecutive days. RESULTS The number of reflux episodes per hour, but not their duration, was significantly increased during SPT compared with MPT (SPT 2.5 (0.4) v MPT 1.6 (0.3), p = 0.007) and to background (1.1 (0.)1, p = 0.0005). Fractional reflux time was also increased during SPT (11.7 (2.6)%) compared with background (6.9 (1.3)%, p = 0.03) but not compared with MPT (10.7 (2.7)%). There was no significant difference between MPT and background for number of reflux episodes, their duration, or fractional reflux time. CONCLUSION SPT, but not MPT, was associated with a significant increase in gastro-oesophageal reflux in infants with cystic fibrosis.

Peter D Phelan - One of the best experts on this subject based on the ideXlab platform.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Background: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. Aims: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. Methods: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT–SPT; day 2: SPT–MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30° head-down tilt). Results: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. Conclusions: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy gastro oesophageal reflux and arousal in infants with cystic fibrosis
    Archives of Disease in Childhood-education and Practice Edition, 2004
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    BACKGROUND: Postural Drainage chest physiotherapy in infants with cystic fibrosis (CF) exacerbates gastro-oesophageal reflux (GOR) and may contribute to a more rapid deterioration in lung function. AIMS: To compare standard Postural Drainage chest physiotherapy (SPT) and a modified physiotherapy regimen (MPT) without head-down tilt, with regard to GOR, arousal state, and cardiorespiratory function. METHODS: Twenty infants with CF underwent 30 hour oesophageal pH monitoring, during which four chest physiotherapy sessions were administered (day 1: MPT-SPT; day 2: SPT-MPT). Arousal state, heart rate, and oxygen saturation were documented for each of the physiotherapy positions (supine, prone, right lateral, and left lateral with (SPT) or without (MPT) 30 degrees head-down tilt). RESULTS: Significantly more reflux episodes occurred during SPT than during MPT, but there were no significant differences in median episode duration or fractional reflux time. During SPT, left lateral positioning was associated with fewer reflux episodes compared to other positions. During supine and prone positioning, more reflux episodes occurred during SPT than during MPT. Infants were significantly more likely to be awake or cry during SPT. There was a significant association between crying and reflux episodes for SPT. Non-nutritive sucking was associated with a significant reduction in reflux episodes during SPT. Oxygen saturation during SPT was significantly lower during crying and other waking, and non-nutritive sucking during SPT was associated with a significant increase in oxygen saturation. CONCLUSIONS: SPT is associated with GOR, distressed behaviour, and lower oxygen saturation.

  • chest physiotherapy in infants with cystic fibrosis to tip or not a five year study
    Pediatric Pulmonology, 2003
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky, Michael Ditchfield, Ian Story
    Abstract:

    There is controversy about the need for Postural Drainage physiotherapy in asymptomatic infants with cystic fibrosis (CF). We aimed to compare the effectiveness of standard Postural Drainage chest physiotherapy (SPT) with a modified physiotherapy regimen without head-down tilt (MPT) in young infants with CF. Twenty newly diagnosed infants with CF (mean age, 2.1 months; range, 1–4) were randomized to SPT or MPT. Parents kept a detailed symptom and treatment diary for the following 12 months. Serial chest radiographs, taken at diagnosis, 12 months, 2½ years, and 5 years after diagnosis, were assessed using the Brasfield score. Pulmonary function tests were compared between groups after 5 years. Of the 20 infants, 16 (80%) completed the review at 12 months, and 14 (70%) at 2½ and 5 years. Patients receiving SPT had more days with upper respiratory tract symptoms than those on MPT (70 ± 32.8 vs. 37 ± 24.9 days; P = 0.04) and required longer courses of antibiotics (23 ± 28.5 vs. 14 ± 11.2 days; P = 0.05). Chest x-ray scores were similar at diagnosis but were worse at 2½ years for those receiving SPT (P = 0.03). Forced vital capacity and forced expired volume in 1 sec (FEV1) at 5–6 years was lower for SPT than for MPT (P < 0.05). In conclusion, MPT was associated with fewer respiratory complications than SPT in infants with CF. Pediatr Pulmonol. 2003; 35:208–213. © 2003 Wiley-Liss, Inc.

  • Postural Drainage in cystic fibrosis is there a link with gastro oesophageal reflux
    Journal of Paediatrics and Child Health, 1998
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan
    Abstract:

    Objectives: To determine the clinical effects of a change from Postural Drainage (PD) to positive expiratory pressure chest physiotherapy (PEP) in children with cystic fibrosis (CF) and symptoms of gastro-oesophageal reflux (GOR). To measure the effects of PD on GOR in children with CF. Methods: Study 1: Six adolescents with CF and symptoms of GOR during PD were changed to upright PEP physiotherapy. The effects on lung function, reflux symptom scores and annual hospital days were measured. Study 2: Twenty-four children with CF (mean age 11 years) and symptoms suggestive of GOR underwent 24-h pH monitoring, including periods of chest physiotherapy. Results: Study 1: All six patients reported a reduction in reflux symptoms during PEP therapy (P<0.001). Lung function parameters improved during the first 6 months of PEP (P<0.001). This improvement was sustained for a further 18 months. Annual hospital days decreased significantly (P<0.0005). Study 2: Nine of 24 patients (37.5%) had pathological GOR. Reflux episodes were significantly increased during PD (P<0.0001), as was fractional reflux time (P<0.01). Conclusions: Upright PEP physiotherapy may be more appropriate than PD in selected patients with CF and symptomatic GOR. The role of GOR as a cofactor in the progression of pulmonary disease in CF needs further evaluation.

  • Postural Drainage and gastro oesophageal reflux in infants with cystic fibrosis
    Archives of Disease in Childhood, 1997
    Co-Authors: Brenda M Button, Ralf G Heine, Anthony G Cattosmith, Peter D Phelan, Anthony Olinsky
    Abstract:

    Gastro-oesophageal reflux is increased in cystic fibrosis and it is possible that Postural Drainage techniques may exacerbate reflux, potentially resulting in aspiration and further impairment of pulmonary function. AIM To evaluate the effects of physiotherapy with head down tilt (standard physiotherapy, SPT) on gastro-oesophageal reflux and to compare this with physiotherapy without head down tilt (modified physiotherapy, MPT). METHOD Twenty (mean age 2.1 months) infants with cystic fibrosis underwent 30 hour oesophageal pH monitoring during which SPT and MPT were carried out for two sessions each on consecutive days. RESULTS The number of reflux episodes per hour, but not their duration, was significantly increased during SPT compared with MPT (SPT 2.5 (0.4) v MPT 1.6 (0.3), p = 0.007) and to background (1.1 (0.)1, p = 0.0005). Fractional reflux time was also increased during SPT (11.7 (2.6)%) compared with background (6.9 (1.3)%, p = 0.03) but not compared with MPT (10.7 (2.7)%). There was no significant difference between MPT and background for number of reflux episodes, their duration, or fractional reflux time. CONCLUSION SPT, but not MPT, was associated with a significant increase in gastro-oesophageal reflux in infants with cystic fibrosis.