Physical activity in patients with cystic fibrosis: a new variable in the health-status equation unravelled?

During the past few years, it has become clear that in chronic respiratory disease, health status is severely impaired and that this should be a prime target for treatment, both in patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) 1, 2. Lung function impairment is relatively poorly related to impaired health status in COPD patients 3. The same concepts appear to apply in CF patients 2. Indeed, evidence is available demonstrating that aerobic capacity in these patients is related to survival 4, quality of life 2 and professional achievements 5. Exercise training programmes have been developed for chronic respiratory illness, and their popularity has increased tremendously since the late 1990s. In COPD, exercise training clearly enhances functional exercise capacity and health status and reduces the utilisation of healthcare resources 6, 7. Indirect indications suggest it may also improve survival in these patients, but, to date, no direct evidence to this effect has been provided 6. A clear demonstration of this effect would require a large study, which may no longer be ethically acceptable as the benefits of exercise training (in terms of functional exercise capacity and health status) have now been demonstrated beyond doubt. Similar effects were demonstrated in patients with CF, although on average the studies were understandably smaller 8. …