Condition category
Nutritional, Metabolic, Endocrine
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Mrs Catherine Alexandra Sandsund


Contact details

Royal Brompton & Harefield NHS Trust
Sydney Street
United Kingdom
+44 020 7352 8121 (X4925)

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title


Study hypothesis

Do gentle mobilisations to the bones of the rib cage and treatment of the muscles in the surrounding areas improve lung function (forced expiratory volume in one second) in adults with cystic fibrosis?

Ethics approval

Approved by by Brompton, Harefield & NHLI Ethics Committee on 27/11/2006.REC reference number: 06/Q0404/81.

Study design

Randomised controlled pilot study

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Nutritional, Metabolic, Endocrine: Cystic fibrosis


The Patient Advocate for Cystic Fibrosis, Royal Brompton & Harefield NHS Trust, the Senior Research Fellow in Physiotherapy, Dr Jennifer Pryor, and Senior Medical Consultant of the Department of Cystic Fibrosis, Professor Margaret Hodson, have participated in the formulation of the proposal. Professor Margaret Hodson, Dr Khin Gyi and Dr Sarah Elkin have agreed that their patients may be invited to participate in the study when it has received ethical approval.

The inclusion of a series of physiotherapy joint and muscle movement techniques (musculoskeletal) techniques to current optimal care for the treatment of people with cystic fibrosis will lead to short term improvements in lung function, posture and exercise capacity.

1.Written informed consent will be obtained for all subjects before entering the study.
2.Up to twenty patients will be randomised to a control group, to continue with their normal optimal care, or to a treatment group where they will receive musculoskeletal physiotherapy sessions once a week, for six weeks, at Royal Brompton Hospital in addition to their current optimal care.
3. An independent observer (blind to the subject's randomisation) will, after consent is signed, collect the baseline data, undertake the tests for exercise capacity, the measurements for posture and chest wall mobility, and administer the qualitative questionnaires for pain and for quality of life related to physical functioning.
4.The independent observer will then undertake repeated measurements of lung function, exercise capacity, posture, chest wall mobility, and administer the qualitative questionnaires for pain and for quality of life related to physical functioning for all subjects at week three, six and twelve.
5. Full lung function tests will be undertaken in the Lung Function Laboratory (with the physiologist blind to the subject's randomisation) at baseline and after the six-week treatment period. When possible the subject's annual review lung function data will be used as the baseline measurement, to avoid duplication of these tests.
6. At the end point of the study subjects will be asked to complete a questionnaire.

The study will take place over twelve weeks from recruitment to final assessment. The
treatment and control groups will attend four times for a total of one hour for assessment.
The treatment group will also attend six treatment sessions which will take up to one hour. Two of those sessions will be on the same day as the independent measurements and will therefore take approximately two hours for the treatment group.

Statistical analysis:
The statistical analysis has been discussed with Mr Michael Roughton, Statistician, Royal Brompton & Harefield NHS Trust and Imperial College London and his advice taken.

Intervention type



Not Specified

Drug names

Primary outcome measure

For the treatment group, outcome measures will be taken 30 minutes after treatment. For the control group these will be taken 15 to 30 minutes after arrival for assessment. The primary outcome measure will be forced expiratory volume in one second.

Secondary outcome measures

1. Other measures of lung function: forced vital capacity, peak expiratory flow rate, residual volume as a percent of total lung capacity
2. Modified shuttle test, monitoring oxygen saturation and heart rate and Borg CR10 scale of perceived exertion
3. Visual analogue scale for pain: a qualitative subjective assessment using a 10-centimeter scale
4. The Cystic Fibrosis Quality of Life Questionnaire, section one: physical functioning (Questionnaire I)
5. Flexi curve measurements of posture in standing
6. Chest wall excursion measurements using a tape measure for the circumference of the chest wall at axilla (armpit) and xiphisternal (lower chest) level
7. A questionnaire using a series of visual analogue scales with room for individual comment (Questionnaire II)

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

Added June 2008:

1. Reported postural changes, stiffness, discomfort and/or pain of musculoskeletal origin in the thoracic spine or chest wall
2. Diagnosis of cystic fibrosis (confirmed by genotype or a sweat sodium concentration of >70mmol/l or sweat chloride of >60mmol/l)
3. Sixteen years of age or over
4. Patients in a stable clinical state with lung function at the time of entry that is within 10% of the mean of the last two recordings (separated by at least one month).
5. Forced Expiratory Volume in 1 second (FEV1) ≥30% predicted at time of entry to the study

Participant type


Age group



Not Specified

Target number of participants


Participant exclusion criteria

Added June 2008:
1. Evidence of a current respiratory exacerbation (worsening) as defined by Thornton et al. 2004
2. Cor pulmonale (right heart failure)
3. Low bone density (Z score < -3)(WHO Study Group 1994)
4. Previous history of spontaneous fractures
5. Past history of spinal fracture or other known arthopathic (joint) or spinal disease process
6. Currently undergoing musculoskeletal (physiotherapy, chiropractic or osteopathic) treatment
7. Pregnancy
8. Inability to give consent
9. Current enrolment in another research trial

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Royal Brompton & Harefield NHS Trust
United Kingdom

Sponsor information


Record Provided by the NHSTCT Register - 2007 Update - Department of Health

Sponsor details

The Department of Health
Richmond House
79 Whitehall
United Kingdom
+44 (0)20 7307 2622

Sponsor type




Funder type


Funder name

Royal Brompton and Harefield NHS Trust (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Funder name

No External Funding

Alternative name(s)

Funding Body Type

Funding Body Subtype


Funder name

NHS R&D Support Funding

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

1. 2011 results in

Publication citations

  1. Results

    Sandsund CA, Roughton M, Hodson ME, Pryor JA, Musculoskeletal techniques for clinically stable adults with cystic fibrosis: a preliminary randomised controlled trial., Physiotherapy, 2011, 97, 3, 209-217, doi: 10.1016/

Additional files

Editorial Notes