[Physical activity and exercise training for patients with cystic fibrosis]. / Activité physique et réentraînement à l'effort du patient atteint de mucoviscidose.

In France patients with cystic fibrosis benefit from a multidisciplinary follow-up in Cystic Fibrosis Centres. In this follow-up, despite the numerous therapeutic benefits of exercise in this disease, little emphasis is placed on the promotion of physical activity. The aim of this article is to improve this aspect of management, giving advice from a working group of experts, based on the medical literature and clinical experience. These proposals include quantification of physical activity, evaluation of exercise, training and rehabilitation programs and finally, modification of behaviour to include physical activity in the overall cystic fibrosis treatment strategy. It is intended to set up multicentre studies to evaluate the impact of these proposals.

Nifedipine in chronic bronchial asthma: a randomized double-blind crossover trial against placebo.

Calcium-channel blockers such as verapamil and nifedipine have been shown to inhibit exercise-induced asthma as well as acutely induced bronchoconstriction, but little is known of their chronic effects, if any, on bronchial asthma. Nifedipine, 60 mg/day for 3 weeks, was compared to placebo in a double-blind randomized crossover study, as an addition to the usual treatment of 11 patients with severe chronic bronchial asthma. Nifedipine decreased the weekly duration of the attacks (102 +/- 34 vs 193 +/- 49 min, p less than 0.05), the number of betamimetic puffs inhaled per week (13 +/- 3 vs 18 +/- 4, p less than 0.05), and the duration of intercritical dyspnoea (7.9 +/- 3.9 vs 15.9 +/- 2.3 h, p less than 0.05) without significantly changing the number of asthma attacks (4.8 +/- 1.2 vs 4.7 +/- 1.7, NS). Nifedipine did not significantly change basal respiratory function, nor did it change heart rate or blood pressure. Side effects were noted in 5 patients taking nifedipine, leading to a decrease in the dosage to 30 mg per day in 3, and in one patient taking placebo. In this study nifedipine had essentially subjective effects, but these warrant a longer-term study of nifedipine or other calcium antagonists in the treatment of bronchial asthma.