Resistive Inspiratory Manoeuvre as Airway Clearance Technique in Cystic Fibrosis
Resistive Inspiratory Manoeuvre as Airway Clearance Technique in Cystic Fibrosis
This trial aims to analyze whether the resistive inspiratory manoeuvre (RIM) performed
 previously to autogenic drainage (AD) technique improves the effectiveness in terms of mucus
 clearance during a typical bronchial drainage session in adults, stable CF patients.
It is a multicenter study. 4 different Spain Cystic Fibrosis Foundations are included in the
 study (Madrid, Valencia, Murcia and Aragón). All patients will perform three different arms
 of treatment in a crossover randomization. Each arm of treatment will be apply only in one
 session. The wash-out period will be one week. Before starting the trial, all patients will
 perform a control session without any intervention, only the outcome measures will be assess.

 During the study period the patients' pharmacological treatment remained unchanged
Inclusion Criteria:

 -  Cystic Fibrosis (CF) diagnosed ( established by genotype or sweat sodium>70 mmol/l or
 sweat chloride of>60 mmol/l)

 -  Clinically stable at time of study entry (defined as no requirement for antibiotics or
 change in respiratory medication in the preceding 4 wk);

 -  Chronic sputum production, at least ≥ 15 ml /24h

 -  Familiar and trained in the use of autogenic drainage technique (at least 6 months)
 and resistive inspiratory manoeuvre (at least three previous sessions)

 -  To be able to provide written, informed consent

 Exclusion Criteria:

 -  Lung function: Forced expiratory volume in 1 second < 30 % pred . ; Forced vital
 capacity < 40 % pred.

 -  Active haemoptysis during the previous month

 -  Supplemental oxygen or non-invasive ventilation (NIV)