Until further work has been done in this area, it may be reasonable to apply electrical stimulation for the treatment and prevention of contracture, especially
as it is inexpensive, well tolerated, and not associated with harm. eAddenda: Table 5 SKI-606 in vitro available at jop.physiotherapy.asn.au Ethics: The study was approved by the ethics committees of the Northern Sydney Central Coast Area Health Service and the participating hospitals. Written consent was obtained from all the participants or their legal guardians before data collection began. Competing interests: Nil Support: Motor Accidents Authority (NSW) Grants. We thank the staff and participants of the Royal Rehabilitation Centre Sydney, Balmain Hospital and Liverpool Hospital.
We also thank Davide de Sousa, Erin Doyle, Victoria Podmore, Lakshmi Arunachalam, Jane Liu, Katarina Stroud and Jo Diong for their assistance, and the occupational therapists of all the participating units for fabricating the hand splints. “
“People with cystic fibrosis have a genetic mutation that dehydrates the airway epithelium, impairing the clearance U0126 of airway secretions by mucociliary clearance and cough (Boucher 2007). This impaired clearance leads to a cycle of mucus obstruction, infection, and inflammation. The chronic lung infection that ensues is characterised by gradual progressive decline in lung function interspersed with acute exacerbations, and eventual respiratory failure (Ratjen 2009). Although prognosis has improved markedly for people with cystic fibrosis over the past few decades, cystic fibrosis remains a life-shortening disease with respiratory failure still accounting for the majority of mortality (Viviani et al 2012). Therefore, it is important to identify and use interventions that target this pathogenic pathway. Several categories
of interventions are used to treat mucus obstruction and infection in people with cystic fibrosis. Antibiotics are used to suppress infection (Doring et al 2000), various mucoactive medications are used to improve both Oxalosuccinic acid the patency of the airways and the physical properties of the mucus to aid its clearance (Heijerman et al 2009, Bishop et al 2011), and a range of physical techniques are used to dislodge mucus and to facilitate its expectoration. These physical techniques may include positioning, manual techniques, positive pressure devices, breathing techniques, and exercise (van der Schans et al 2000). Although airway clearance is a widely recommended goal of treatment in the management of cystic fibrosis lung disease (Flume et al 2009), people with cystic fibrosis typically have low adherence to their airway clearance regimen despite being aware of its importance (Myers 2009). At various stages of disease progression, people with cystic fibrosis may view airway clearance as an inconvenience.