Modeling of Chest Physiotherapy Using Impedance Measurements (PHYSIOMOD)
Condition: Cystic Fibrosis
MeSH terms: Cystic Fibrosis; Fibrosis
Study type: Interventional

Summary: 
      "The usefulness of respiratory physiotherapy and its execution modalities remains highly
      debated even though reviews of the literature show that respiratory physiotherapy is able to
      improve the drainage of bronchial secretions and pulmonary function tests during cystic
      fibrosis in periods of stability. Different physiotherapy techniques have been developed but
      the choice of one or the other facing a patient can not currently be recommended. The
      VirtualChest project, supported by a grant from the National Agency for Research (ANR), aims
      to develop and validate a physical model of respiratory physiotherapy (6 stages including
      model establishment pulmonary: bronchial tree and pulmonary mechanics and parietal [steps 1
      and 3], a model of mucus [step 2] and modeling the effect of physiotherapy [step 5]). This
      project is integrated with stages 3 and 5 of this broad project and aims to get on a limited
      number of children with cystic fibrosis a proof of concept (prediction of drainage
      efficiency) and especially to feed the proposed physical models in order to subsequent
      optimization of the model (step 6). The choice cystic fibrosis of the child was justified by
      the effect demonstrated respiratory physiotherapy, particularly on respiratory functional
      criteria, and the fact that the parietal mechanics varies physiologically at this age."
    

Detailed description: 
      "The clinical study will consist in carrying out, before and after hospital respiratory
      physiotherapy, a measure impedance of the respiratory system by forced oscillations (IOS,
      impulsometry: measurement during tidal breathing) and a measurement anatomical dead space
      (duration of the two measurements: 10 minutes). The physiotherapist will make an initial
      diagnosis (degree of bronchial obstruction), fill a form describing the modalities of the
      physiotherapy session (methods used) and will evaluate the sputum volume got. On a limited
      number of children (n = 6), expiratory flow will be measured during the session of
      physiotherapy ; these measures will be carried out in hypersecreting children able to support
      a face mask during the session and having had or before have a chest CT scan within 6 months.
      The objective is to establish a correlation between sputum volume and the degree of
      improvement of functional respiratory parameters, to establish criteria of central and / or
      peripheral effect of physiotherapy (""simple"" modeling obtained from measurements impedance
      of the respiratory system) and to obtain the flow rates necessary and sufficient to mobilize
      bronchial secretions. The data from this phase will allow to fuel the ""complex"" physical
      model (distribution mucus in the airways). Moreover, for each of the patients will be
      recovered the possible scanner performed within ± 6 months of the physiotherapy session which
      will allow the extraction of the morphology of the airways of the patient. The goal is to get
      in at least 6 patients a specific morphology of the airways and determine if this morphology
      implementation allows to improve the model compared to the use of generic modeling or airway
      tree. A total of 30 elderly Cystic Fibrosis children at least 4 years will be prospectively
      included."
    

Intervention name(s): chest physiotherapy
Intervention type(s): Other
Intervention description(s): chest physiotherapy
Intervention model: Single Group Assignment
Intervention model description: one arm, the interventional design is related to additional pulmonary function tests
Masking: None (Open Label)
Primary purpose: Basic Science