Revisión sistemática acerca de la efectividad de la fisioterapia respiratoria en pacientes adultos con fibrosis quística.

Abstract

Introducción: La fibrosis quística (FQ) es una enfermedad hereditaria autosómica recesiva presente en todo el mundo. Está causada por mutaciones de un gen que codifica la proteína CFTR. En la FQ está presente una alteración en el transporte de iones cloruro a través de las membranas celulares, produciendo un moco espeso y viscoso. Esto provoca obstrucción de las vías respiratorias y atrapa gérmenes produciendo inflamación, infecciones e insuficiencia respiratoria. Uno de los pilares fundamentales en el tratamiento de la FQ es la fisioterapia respiratoria (FR), ya que consigue mejorar la calidad de vida de las personas y, además, disminuye la dependencia del tratamiento hospitalario, pudiendo retrasar lo máximo posible el trasplante de pulmón. Objetivos: Analizar la evidencia científica actual sobre la efectividad de la fisioterapia respiratoria en el tratamiento de pacientes adultos con fibrosis quística, además de comparar la evidencia actual de las distintas técnicas de FR. Metodología: Se realiza una revisión sistemática de la literatura disponible en las bases de datos Pubmed, PEDro y Cochrane Library. Se incluyeron estudios publicados en los últimos 11 años, realizados con participantes mayores de 15 años. Resultados: Se seleccionaron 10 estudios en los que las distintas técnicas de fisioterapia respiratoria y/o ejercicio físico son utilizados como pilares fundamentales para el tratamiento de la FQ. Conclusiones: Según la evidencia actual, se puede determinar que la FR mejora la calidad de vida de los adultos con FQ y actúa eficazmente en la depuración de las vías respiratorias. Sin embargo, se desconoce qué tratamiento produce una mayor mejora en la función pulmonar y, por tanto, se necesita mayor investigación sobre el tema.

Introduction: Cystic fibrosis (CF) is an autosomal recessive inherited disease present worldwide. It is caused by mutations of a gene encoding the CFTR protein. In CF, an alteration in the transport of chloride ions across cell membranes is present, producing a thick, viscous mucus. This causes obstruction of the airways and traps germs leading to inflammation, infections, and respiratory failure. One of the fundamental pillars in the treatment of CF is respiratory physiotherapy since it manages to improve the quality of people´s lives, reduces dependence on hospital treatment. Furthermore, it can delay lung transplantation as much as possible. Objectives: To analyze the current scientific evidence on the effectiveness of respiratory physiotherapy in the treatment of adult patients with cystic fibrosis, as well as to compare the current evidence of the different RF techniques. Methodology: A systematic review of the literature available in the Pubmed, PEDro and Cochrane library databases was carried out. We included studies published in the last 11 years, performed with participants older than 15 years old. Results: 10 studies were obtained in which different respiratory physiotherapy techniques or physical exercise are used as fundamental pillars for the treatment of CF. Conclusions: Based on current evidence, it can be determined that respiratory physiotherapy improves quality of life in adults with CF and acts effectively in airway clearance. However, it is unknown which treatment produces a greater improvement in lung function and, therefore, more research on the subject is needed.

Introduction: Cystic fibrosis (CF) is an autosomal recessive inherited disease present worldwide. It is caused by mutations of a gene encoding the CFTR protein. In CF, an alteration in the transport of chloride ions across cell membranes is present, producing a thick, viscous mucus. This causes obstruction of the airways and traps germs leading to inflammation, infections, and respiratory failure. One of the fundamental pillars in the treatment of CF is respiratory physiotherapy since it manages to improve the quality of people´s lives, reduces dependence on hospital treatment. Furthermore, it can delay lung transplantation as much as possible. Objectives: To analyze the current scientific evidence on the effectiveness of respiratory physiotherapy in the treatment of adult patients with cystic fibrosis, as well as to compare the current evidence of the different RF techniques. Methodology: A systematic review of the literature available in the Pubmed, PEDro and Cochrane library databases was carried out. We included studies published in the last 11 years, performed with participants older than 15 years old. Results: 10 studies were obtained in which different respiratory physiotherapy techniques or physical exercise are used as fundamental pillars for the treatment of CF. Conclusions: Based on current evidence, it can be determined that respiratory physiotherapy improves quality of life in adults with CF and acts effectively in airway clearance. However, it is unknown which treatment produces a greater improvement in lung function and, therefore, more research on the subject is needed.