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Exercise as it relates to Disease/Exercise effects on Cystic Fibrosis
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Effect of Exercise as Treatment for Cystic Fibrosis (CF)
Brief Background
Common autosomal genetic disease Stuhrmann, M., et al., (2000)Mutation screening for prental and presymtomatic diagnosis: Cystic fibrosis and Haemochromatosis, Eur J Pediatr, 159(3), 186-191. causing problems in the respiratory and digestive systems. It is caused by a mutation of the Cystic Fibrosis Transmembrane Regulatory (CFTR) gene in the exocrine.Farjadian, S., et al., (2013) Clinical and genetic features in patients with cystic fibrosis in south western Iran, Short communication 23(2) pp212-215
Explanation/Diagnosis of CF
Diagnosis usually occurs during early childhood and two main criteria used to diagnose CF include:
Genetic Testing (prenatal or early childhood)
Sweat Test (sodium chloride levels)
To help confirm the clinical diagnosis, medical specialists will look for the following symptoms:
Chronic cough
Trouble breathing
Repeated chest infections
Poor weight gain
Diarrhea/constipation
Salty sweat
Treatment
Exercise Orenstein, D., et al., (1981) Exercise coniditoning and cardiopulmonary fitness in cystic fibrosis: The effects of a three month supervised running program, Clinical investigations, 80(4), 392-398 as treatment for CF patients in conjuction with more traditional treatments has been found to have positive effects, including:
Increased exercise capacity Enright, S., et al., (2004) Inspiratory muscle training improves lung function and exercise capacity in adults with cystic fibrosis, Chest journal, 126(2), 406-411
Improved cardiorespiratory fitness
Improved pulmonary function
Treating CF through the use of medications is one of the more traditional methods to limit or inhibit the symptoms of CF. Azithromycin Wolter, J., et al (2002) Effects of long term treatment with azithromycin on disease parameters in cystic fibrosis: A randomized trial, Thorax, 57(3), 212-216 and tobramycin Gibson, R., et al., (2002) Significant microbiologic effect of inhaled tobramycin in young children with cystic fibrosis, American Thoracic Society, 44(3), 1-15 are two significant antibiotics that are beneficial towards treating CF.
Azithromycin (prevents bacteria growth)
Tobramycin (inhibits mRNA translation)
However, side effects of these medications can include:
Hearing Loss
Diarrhea
Vomiting
Chest Physiotherapy Zach, M., et al., (1982) cystic fibrosis: Physical exercise vesus chest physiotherapy, Archives of disease in childhood, 57, 587-589 administered by a parent, partner or physiotherapist following exercise has also been found to be beneficial towards inhibiting the symptoms associated with CF.
Recommendations
CF patients should consult their general practitioner before starting an exercise program and from there can create a schedule suited to themself.Bradely, J., Moran, F., (2012) Physical training for cystic fibrosis, The Cochrane collaboration, 1, 2-56
A minimum of 30 minutes of moderate to high intensity exercise should be performed 3-4 times a week in whatever physical activity the patient feels comfortable with.
Further Reading
Cystic Fibrosis Australia Cystic Fibrosis Federation Australia (2013), https://www.cysticfibrosis.org.au/
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