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.