Department of Paediatrics, 2nd Medical Faculty, Charles University and Motol University Hospital, Prague, Czech Republic.
Department of Rehabilitation and Sports Medicine, 2nd Medical Faculty, Charles University and Motol University Hospital, Prague, Czech Republic.
Pediatr Pulmonol. 2021 Jun;56(6):1558-1565. doi: 10.1002/ppul.25350. Epub 2021 Mar 13.
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.
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 (LCI ) derived from a nitrogen multiple breath washout test. Secondary outcomes included changes in regional ventilation inhomogeneity (indices of acinar [SacinVt] and conductive airway [ScondVt] 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.
After the RST intervention, the LCI (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 LCI after RST.
RST has multiple positive short-term effects on lung function, especially in CF patients with trunk deformities.
反射区刺激技术（RST）可激活复杂的运动反应，对运动系统有积极影响。该技术还可能间接影响呼吸；然而，该技术作为囊性纤维化（CF）治疗的辅助手段尚未得到明确。
我们进行了一项随机对照单中心干预试验，以评估 21 例基线肺功能正常的儿科 CF 患者接受 30 分钟 RST 对肺功能的短期影响。采用交叉设计比较 RST 与假治疗的效果。干预措施以随机顺序进行，间隔 6 个月计划一次。主要结局是通过氮多次呼吸冲洗试验得出的肺清除指数（LCI）评估干预后整体通气不均一性的变化。次要结局包括区域性通气不均一性（腺泡[SacinVt]和传导气道[ScondVt]不均一性指数）和肺功能参数（吸气量、用力肺活量和 1 秒用力呼气量）的变化。研究开始时，理疗师评估了脊柱畸形。
RST 干预后，LCI（p=0.004）和 Scond*Vt（p=0.009）显著降低，而吸气量增加（p=0.012）。在假治疗组，所有参数均无显著变化。所有患者中有 76.5%存在脊柱畸形，92.9%有脊柱畸形的患者在 RST 后 LCI 降低。
RST 对肺功能有多种积极的短期影响，特别是在脊柱畸形的 CF 患者中。
