Statement 11: A physiotherapist with a specific expertise
in respiratory rehabilitation should be part of the multidisciplinary
team in order to define the most appropriate therapeutic strategy for
the individual patient.
A very high consensus was reached by the expert panel on this statement
(Figure 6 ). In final consensus meeting, there was unanimous
response to this statement. The respiratory rehabilitation program for
CF patients often includes aerosol therapy, the management of which is
also the responsibility of the physiotherapist and not just the
clinician.
It is now widespread opinion that CF patients should be cared for by
physiotherapists with an appropriate level of expertise in CF management
and there should be adequate staffing levels to maintain these standards
of care. The physiotherapist represents a valid interface both for the
clinician and for the patient who often feels freer and more uninhibited
in reporting doubts and uncertainties related to therapies.
The findings of an Italian survey indicated that physiotherapists play a
key role in the care of Italian CF patients, by performing inhaled
therapies and educating patients and families to their
use58. Most physical therapists actively participate
and provide hands-on demonstrations to patients and
caregivers58.
These data are coherent with the role of physiotherapists involved in
the respiratory care of cystic fibrosis as outlined in the ECFS
standards of care59. The CF physiotherapist should
also implement strategies for the management of complications or
comorbidities experienced by the ageing patient59. All
interventions should be tailored to the individual patient, with
consideration of his age, severity of disease, physical side-effects or
complications, and social and domestic conditions59.