1. BELLARMINE UNIVERSITY, LOUISVILLE, KY Cystic Fibrosis Exercise, and Quality of Life Presented by: John Hardy, Adam Hooten, Andrew Stethen, and Cody Russell http://med.stanford.edu/ism/2010/february/cystic-fibrosis-0208.html http://app1.unmc.edu/publicaffairs/todaysite/sitefiles/today_full.cfm?match=1503

2. BELLARMINE UNIVERSITY, LOUISVILLE, KY Becky Foster (Adam Hooten’s Aunt)

3. BELLARMINE UNIVERSITY, LOUISVILLE, KY P.I.C.O P.- Adults with cystic fibrosis I.- Physical activity C.- Inactivity O.- Decreased hospitalizations and exacerbations http://blog.prashantgorule.com/wp- content/uploads/2011/12/Albert-Einstein-pic.png

4. BELLARMINE UNIVERSITY, LOUISVILLE, KY Cystic Fibrosis -”inherited disease of the secretory glands” -National Heart, Lung, and Blood Institute -Organs mainly affected: -Lungs -Pancreas -Liver -Intestines -Sinuses -Sex organs http://www.ilquotidianoitaliano.it/gallerie/2011/01/news/chopin-le-sue- allucinazioni-colpa-dell%E2%80%99epilessia-53847.html/

5. BELLARMINE UNIVERSITY, LOUISVILLE, KY Other Names For Cystic Fibrosis: -Cystic Fibrosis of the pancreas -Fibrocystic disease of the pancreas -Mucoviscidosis -Mucoviscidosis of the pancreas -Pancreas fibrocystic disease -Pancreatic cystic fibrosis Andrew Simmons Nathan Charles http://www.zimbio.com/pictures/Pn8gQIz6yw0/Super+ 14+Rd+8+Western+Force+v+Stormers/ZsYbhPuhZJe /Nathan+Charles http://wwewallpaper4u.blogspot.com/2011/11/w we-umaga-wallpaper.html

6. BELLARMINE UNIVERSITY, LOUISVILLE, KY Cystic Fibrosis Epidemiology: – Highest among Caucasians of Northern Europedescent. Signs and Symptoms - – Variable Diagnosis - – Series of tests: Fraser Brown http://tutongkita.blogspot.com/2010/05/kerajaan-baru-uk-dalom-gambar.html

7. BELLARMINE UNIVERSITY, LOUISVILLE, KY P.I.C.O P.- Adults with cystic fibrosis I.- Physical activity C.- Inactivity O.- Decreased hospitalizations and exacerbations http://discovermagazine.com/2013/september/14-doorway-to-a-cure

8. BELLARMINE UNIVERSITY, LOUISVILLE, KY Results -QOL is proven directly correlated with hospitalizations and exacerbation. Conclusion: -QOL assessments are clinically feasible and practical to monitor in regards to CF Goldbeck 2006

9. BELLARMINE UNIVERSITY, LOUISVILLE, KY Sahlberg 2008 Results: -Max HR remained unchanged -Max workload and maximal VO 2 improved significantly. Conclusions: - Endurance training alone improved cardio-pulmonary function

10. BELLARMINE UNIVERSITY, LOUISVILLE, KY Results: -Intervention group reported significant increase in sports activities -No difference between groups with reported infections -Significant intervention effect on peak VO2 -No significant effect on the QOL scale Conclusion: -No long term significant changes in the QOL Hebestreit 2010

11. BELLARMINE UNIVERSITY, LOUISVILLE, KY Results: -Significant increases in PWC, VC, TLC, Pimax, SPimax -Decrease in anxiety and depression Conclusion: -IMT program resulted in significant benefits for CF pts Enright 2004

12. BELLARMINE UNIVERSITY, LOUISVILLE, KY Results: - Significantly increased VO 2 Max -Showed no significant change in QOL except the scores in the domain of treatment burden and emotional functioning -No significant difference in QOL between exercise group and questionnaire group. Conclusion: - Significantly increased VO 2 Max -Could not demonstrate improvement in QOL. Schmidt 2010

13. BELLARMINE UNIVERSITY, LOUISVILLE, KY Bradley 2006 Results: -Evidence supports different types of training including: resistance and aerobic conditioning. Conclusions: -No intervention proven superior to others -Interventions should be used in conjunction with aerobic exercise

14. BELLARMINE UNIVERSITY, LOUISVILLE, KY Abbott 2008 Results: -69% of the original participants completed the follow up. -Higher QOL was associated with better survival. -Pain and physical functioning domains were statistically significant. Conclusions: -The CFQOL questionnaire is a valid predictor of survival in patients with CF.

15. BELLARMINE UNIVERSITY, LOUISVILLE, KY Do PT Interventions Positively Affect QOL? Number of Articles -Graphical depiction of article findings. (Abbot, Bradley, Enright, Goldbeck, Hebestriet, Sahlberg, Schmidt)

16. BELLARMINE UNIVERSITY, LOUISVILLE, KY Summary of Findings Exacerbations and living circumstances significantly impact QOL. Physical functioning and pain are important predictors of survival QOL. Aerobic conditioning can improve cardiovascular function and psychosocial status. Little evidenced to support long-term improvements in QOL through exercise and or other PT interventions.

17. BELLARMINE UNIVERSITY, LOUISVILLE, KY Best intervention is conflicting. –Aerobic Conditioning Exercise indirectly affects QOL. –Exacerbations = +QOL Holistic approach needed to produce long-term affects on QOL. –Physical and psychosocial domains. Conclusions/Discussion

18. BELLARMINE UNIVERSITY, LOUISVILLE, KY References Abbott J, Hart A, Morton A, Dey P, Conway S, Webb A. Can health-related quality of life predict survival in adults with cystic fibrosis?. American Journal Of Respiratory And Critical Care Medicine. 2009;179(1):54-58. Available from: MEDLINE, Ipswich, MA. Published January 2009. Accessed September 26, 2013. Bradley J, Moran F, Elborn S. Evidence for physical therapies in cystic fibrosis: An overview of five Cochrane systematic reviews. Respiratory Medicine. 2006;100(2): 191-201. http://www.sciencedirect.com/science/article/pii/S0954611105005196. Published February 2006. Accessed September 26, 2013. Enright S, Chatham K, Ionescu A, Unnithan V, Shale D. Inspiratory Muscle Training Improves Lung Function and Exercise Capacity in AdultsWith Cystic Fibrosis. Chest. 2004;126(2):405-411. Available from: Academic Search Premier, Ipswich, MA. Published August 2004. Accessed September 26, 2013. Goldbeck L, Zerrer S, Schmitz T. Monitoring quality of life in outpatients with cystic fibrosis: feasibility and longitudinal results. Journal Of Cystic Fibrosis: Official Journal Of The European Cystic Fibrosis Society. 2007;6(3):171-178. Available from: MEDLINE, Ipswich, MA. Published May 2007. Accessed September 26, 2013. Hebestreit H, Kieser S, Kriemler S, et al. Long-term effects of a partially supervised conditioning programme in cystic fibrosis. The European Respiratory Journal. 2010;35(3):578-583. Available from: MEDLINE, Ipswich, MA. Published March 2010. Accessed September 26, 2013. Sahlberg M, Eriksson B, Sixt R, Strandvik B. Cardiopulmonary Data in Response to 6 Months of Training in Physically Active Adult Patients withClassic Cystic Fibrosis. Respiration. 2008;76(4):413-420. Available from: Academic Search Premier, Ipswich, MA. Published November 2008. Accessed September 26, 2013. Schmidt A, Jacobsen U, Oluf Schiøtz P, et al. Exercise and quality of life in patients with cystic fibrosis: A 12-week intervention study. Physiotherapy Theory And Practice. 2011;27(8):548-556. Available from: MEDLINE, Ipswich, MA. Published November 2011. Accessed September 26, 2013.