Comparison of conventional chest physiotherapy and oscillatory positive expiratory pressure therapy in primary ciliary dyskinesia.

BACKGROUND: Chest physiotherapy (CP) is a recommended treatment modality in primary ciliary dyskinesia (PCD). OBJECTIVE: Primary aim was to compare the efficacy and safety of the conventional chest physiotherapy (CCP) and oscillatory positive expiratory pressure therapy (OPEPT). Secondary aims were to compare the exacerbation rate, time until the first exacerbation, patient compliance and comfort between the two CP methods. METHODS: This is a 6 month randomized, controlled crossover trial. Patients >6 years of age with PCD were randomized into two groups, first group was assigned to OPEPT (Acapella®) for 3 months while second group was assigned to CCP. Groups were crossed over to the other modality after a 15-day washout period. Pulmonary function tests (PFTs) and compliance were monitored by monthly clinic visits. RESULTS: There was a significant increase in FEV1 , FEF25-75 , and PEF values (p = .018, p = .020, and p = .016, respectively) in the OPEPT group and in FVC values (p = .007) in CCP group compared to baseline. However PFT increase at 3rd month was not superior to each other with both physiotherapy methods. Median acute pulmonary exacerbation rate and time period until the first exacerbation were similar in both groups (p = .821, p = .092, respectively). Comfort and effectiveness of OPEPT was higher than CCP according to patients (p = .029 and p = .042, respectively). There were no adverse effects with either therapy. CONCLUSIONS: OPEPT was as effective as CCP in PCD patients. OPEPT was more comfortable and effective than CCP according to patients. OPEPT might be an efficient alternative method for airway cleareance in PCD patients.

Validity and reliability of the Turkish version of the Jenkins Sleep Scale in psoriatic arthritis.

OBJECTIVE: The aim of this study is to investigate the validity and reliability of the Turkish version of Jenkins Sleep Scale (JSS) in psoriatic arthritis (PsA). METHODS: Patients with PsA according to Classification Criteria for Psoriatic Arthritis (CASPAR) were included in the study. Data about age, sex, body mass index (BMI), disease duration (month) and joint symptom duration (month) were noted. Psoriatic Arthritis Quality of Life (PsAQoL) Scale was used to assess the quality of life, Multidimensional Assessment of Fatigue (MAF) Scale was used to evaluate fatigue, and Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. The reliability of JSS scale was determined by internal consistency (Cronbach's alpha coefficient). Face validity and construct validity (convergent and divergent validities) were evaluated. The correlation of the JSS with the PSQI, MAF scale, and PsAQoL scale was assessed for convergent validity. The correlation of the JSS with age, body mass index (BMI), duration of joint symptoms and disease duration were assessed for divergent validity. RESULTS: The mean age of 56 patients was 42.71 ± 11.79. The Cronbach's alpha of the JSS was 0.862. The JSS had significant correlations with PSQI (rho = 0.653, P < 0.001), MAF (rho = 0.457, P < 0.001), PsAQoL (rho = 0.496, P < 0.001). There were no significant correlations between JSS and age (rho = - 0.052, P = 0.716), BMI (rho = - 0.085, P = 0.550), disease duration (rho = 0.161, P = 0.276) and duration of joint symptoms (rho = 0.107, P = 0.474). CONCLUSION: The Turkish version of JSS is a valid and reliable instrument in PsA.