West of Scotland Adult Cystic Fibrosis Service
Welcome to the Physiotherapy Service!
How Does Physiotherapy Help?
Physiotherapy is a crucial part of the daily treatment regime required to keep people with cystic fibrosis (CF) as healthy as possible. It can be used for airway clearance, sinus management, problems with posture and continence, staying fit and much more.
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The type and duration of physiotherapy will be different for everyone, and it can be adapted to suit your needs - your CF Physiotherapist will work with you to establish the best routine for you.
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Physiotherapists adapt and optimise treatment regimens throughout the person’s life in line with age and disease progression. They will also offer education and support for patients and their families to enable them to self-manage their condition through essential daily home physiotherapy.
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Exercise and Exercise Testing
As part of your annual review and occasionally throughout the year you may be asked to participate in exercise testing.
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There are a number of reasons for this, for example measuring how a particular treatment has worked, how well you are managing with activities of daily living and also a marker of just how fit you are.
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There are a variety of exercise tests that the physiotherapists will suggest. Some are easy and some are progressive and maximal which means they start easy and get harder as the test goes on.
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Step test- a simple test which will monitor your heart rate and oxygen saturations whilst you are stepping on and off a small step from between 3-12 minutes depending on the test.
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Walk test- this is for 6 minutes and will be continuous walking around cones with distance walked, heart rate, breathlessness and saturations monitored during the test.
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Shuttle run- we have recently re introduced this test which is a little more challenging than the walk test but we hope that most patients will be able to achieve this. Again we are monitoring distance walked, heart rate, breathlessness and oxygen saturations.
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Cardiopulmonary exercise test or CPET -The final test and most challenging of them all is the CPET. This is a bike test conducted in the laboratory at Gartnavel by the respiratory physiologists. This is quite simply the hardest exercise test you will be asked to perform. This allows us to monitor specifically how much oxygen you breathe in, how hard your muscles work and how this affects your heart and lungs. This can help us prescribe treatments and exercise.
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All of these tests are useful for the physiotherapist and the wider team when we are trying to decide on the best way to help you with your CF.
Exercise in General
People with CF should try to achieve the same amount of physical activity levels to those without CF.
For this reason we will recommend that you:
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Participate in about:
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150 minutes (2½ hours) of moderate intensity physical activity each week. This would be where you would exercising at a rating of breathlessness between 3-4 as measured using the modified Borg breathlessness scale ( the scale you will have seen during your exercise test).
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75 minutes (1¼ hours) of vigorous intensity physical activity each week. This would be exercising at a rate of breathlessness between 5-6 as measured using the modified Borg breathlessness scale.
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Include posture and flexibility activities in any exercise programme as this can frequently help with both lung function and airway clearance
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Special Considerations
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Diabetes
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Haemoptysis
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Pneumothorax
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CF related Liver disease
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Pregnancy
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Transplantation
The physiotherapy team would be happy to discuss exercise options with you should you ever experience any of the conditions in the list above. Any advice given will be more specific to you as an individual and therefore too much to write in this section. Please ask your therapist for more information.
BEAM (formerly Pactster)
More recently the CF Trust has worked with a web platform called BEAM.
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This is a website that offers a wide range of exercise options. These are offered as either live yoga sessions or on demand exercises. The activities on this platform are designed for the person with CF and are taught by either physiotherapists working in CF or actual patients with CF. It is all online so there is no risk of cross infection.
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You can register on this site for free by just noting that you attend the West of Scotland Adult CF Unit at the Queen Elizabeth University Hospital. We also have a special unit Communities page where we hope to be able to chat more about the exercise you are trying or have found to be useful. This is also on the BEAM site.
Ambulatory Oxygen
If your respiratory function gets a little worse and you sometimes notice that you get increasingly more short of breath when walking or exercising we may feel that using oxygen for walking and or exercise is important. For this reason we will ask you to take an exercise test which will allow us to identify how much oxygen you require to manage the task without feeling breathless. We will work with the oxygen supply people to find the most suitable oxygen delivery device which will be easy to carry and last long enough for the activity you want to do.
Useful Links
The CF trust and the Association of Chartered Physiotherapists in Cystic Fibrosis (ACPCF) have worked together to produce a series of leaflets to complement the advice and teaching physiotherapists give people with cystic fibrosis.
Here are some general leaflets that you might find useful:
We recommend that these leaflets are only used if they have been given to you by your physiotherapist, who will have decided if it is a suitable treatment for you to undertake. If you have taken this leaflet directly from our website, please do not use it without first consulting with your physiotherapist.
Please take a look at our consensus document, Standards of Care and Good Clinical Practice for the Physiotherapy Management of Cystic Fibrosis for more information on standards of care and good practice in physiotherapy.