Reflex zone stimulation reduces ventilation inhomogeneity in cystic fibrosis: A randomised controlled cross‐over study

• Published in: Pediatric pulmonology Vol. 56; no. 6; pp. 1558 - 1565
• Main Authors: Pleskova, Jana, Koucky, Vaclav, Medunova, Katerina, Vlckova, Blanka, Smolikova, Libuse, Pohunek, Petr
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.06.2021
• Subjects: Cystic fibrosis; lung clearance index; lung function testing; Lungs; reflex zone stimulation technique; Respiration; Spirometry; ventilation inhomogeneity; ventilation inhomogeneity; cystic fibrosis; reflex zone stimulation technique; lung clearance index; lung function testing
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.25350

Background The reflex zone stimulation technique (RST) activates complex motor responses and has a positive impact on the locomotor system. This technique may also indirectly affect breathing; however, the use of this technique as adjunct of the treatment of cystic fibrosis (CF) has not yet been characterised. Methods We performed a randomised controlled single‐centre interventional trial to evaluate the short‐term effects of RST on lung function in 21 paediatric CF patients with normal baseline spirometry. The effect of 30 min of RST was compared to that of sham therapy in a crossover design. The interventions were performed in random order and planned 6 months apart. The primary outcome was a change in global ventilation inhomogeneity after intervention, assessed by lung clearance index (LCI2.5) derived from a nitrogen multiple breath washout test. Secondary outcomes included changes in regional ventilation inhomogeneity (indices of acinar [Sacin*Vt] and conductive airway [Scond*Vt] inhomogeneity) and spirometry parameters (inspiratory capacity, forced vital capacity, and forced expiratory volume in 1 s). Trunk deformity was assessed by physiotherapists at study entry. Results After the RST intervention, the LCI2.5 (p = .004) and Scond*Vt (p = .009) decreased significantly, while inspiratory capacity increased (p = .012). In the sham‐therapy group, none of the parameters changed significantly. Trunk deformity was seen in 76.5% of all patients, and 92.9% of those with trunk deformity showed a decrease in LCI2.5 after RST. Conclusion RST has multiple positive short‐term effects on lung function, especially in CF patients with trunk deformities.