<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03295201</url>
  </required_header>
  <id_info>
    <org_study_id>09.2015.287</org_study_id>
    <nct_id>NCT03295201</nct_id>
  </id_info>
  <brief_title>Clinical Effects of Exercise Program Added to Pulmonary Rehabilitation in Patients With Cystic Fibrosis</brief_title>
  <official_title>Clinical Effects of Exercise Program Added to Pulmonary Rehabilitation in Patients With Cystic Fibrosis</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Marmara University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Marmara University</source>
  <oversight_info>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The aim of this study is to investigate the effects of postural exercise program added to&#xD;
      pulmonary rehabilitation program on quality of life, exercise tolerance and postural&#xD;
      stability in children with Cystic Fibrosis.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Cystic fibrosis (CF) is an autosomal recessive, multisystem involvement disease. The most&#xD;
      important cause of mortality in CF is pulmonary complications. Prevention of pulmonary&#xD;
      complications is only possible with pulmonary rehabilitation. Pulmonary rehabilitation&#xD;
      methods used in CF are called airway cleaning techniques that include postural drainage,&#xD;
      breathing techniques and use of devices. These techniques have not been proven to be superior&#xD;
      to each other. Active cycle of breathing techniques (ACBT) is one of the breathing techniques&#xD;
      used to remove secretions from the lungs.&#xD;
&#xD;
      Pulmonary disease progression in CF causes postural impairment and decrease of exercise&#xD;
      tolerance, which can reduce effectiveness of pulmonary rehabilitation. The aim of this study&#xD;
      is to investigate the effects of postural exercise program added to pulmonary rehabilitation&#xD;
      program on quality of life, exercise tolerance and postural stability in children with CF.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">March 5, 2017</start_date>
  <completion_date type="Actual">November 24, 2017</completion_date>
  <primary_completion_date type="Actual">October 23, 2017</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Triple (Participant, Care Provider, Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Exercise Tolerance</measure>
    <time_frame>Before treatment</time_frame>
    <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Exercise Tolerance</measure>
    <time_frame>6 weeks</time_frame>
    <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Exercise Tolerance</measure>
    <time_frame>3 months</time_frame>
    <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Exercise Tolerance</measure>
    <time_frame>6 months</time_frame>
    <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Quality of Life</measure>
    <time_frame>Before treatment</time_frame>
    <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Quality of Life</measure>
    <time_frame>6 weeks</time_frame>
    <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Quality of Life</measure>
    <time_frame>3 months</time_frame>
    <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Quality of Life</measure>
    <time_frame>6 months</time_frame>
    <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Postural Stability</measure>
    <time_frame>Before treatment</time_frame>
    <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Postural Stability</measure>
    <time_frame>6 weeks</time_frame>
    <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Postural Stability</measure>
    <time_frame>3 months</time_frame>
    <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Postural Stability</measure>
    <time_frame>6 months</time_frame>
    <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Pulmonary Function</measure>
    <time_frame>Before treatment</time_frame>
    <description>Forced expiratory volume in 1 second (FEV1)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Pulmonary Function</measure>
    <time_frame>6 weeks</time_frame>
    <description>Forced expiratory volume in 1 second (FEV1)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Pulmonary Function</measure>
    <time_frame>3 months</time_frame>
    <description>Forced expiratory volume in 1 second (FEV1)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Pulmonary Function</measure>
    <time_frame>6 months</time_frame>
    <description>Forced expiratory volume in 1 second (FEV1)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Spinal Deformity- The Cobb Angle (Researcher 1)</measure>
    <time_frame>Before treatment</time_frame>
    <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Spinal Deformity- The Cobb Angle (Researcher 2)</measure>
    <time_frame>Before treatment</time_frame>
    <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Spinal Deformity- The Cobb Angle (Researcher 1)</measure>
    <time_frame>6 months</time_frame>
    <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Spinal Deformity- The Cobb Angle (Researcher 2)</measure>
    <time_frame>6 months</time_frame>
    <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Spinal Deformity- The Modified Cobb Angle (Researcher 1)</measure>
    <time_frame>Before treatment</time_frame>
    <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Spinal Deformity- The Modified Cobb Angle (Researcher 2)</measure>
    <time_frame>Before treatment</time_frame>
    <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Spinal Deformity- The Modified Cobb Angle (Researcher 1)</measure>
    <time_frame>6 months</time_frame>
    <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Spinal Deformity- The Modified Cobb Angle (Researcher 2)</measure>
    <time_frame>6 months</time_frame>
    <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">22</enrollment>
  <condition>Cystic Fibrosis</condition>
  <arm_group>
    <arm_group_label>Pulmonary rehabilitation+exercise group</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Active cycle of breathing techniques (ACBT) and postural exercise program</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Pulmonary rehabilitation group</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Active cycle of breathing techniques (ACBT)</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Active cycle of breathing techniques (ACBT)</intervention_name>
    <description>ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
    <arm_group_label>Pulmonary rehabilitation group</arm_group_label>
    <arm_group_label>Pulmonary rehabilitation+exercise group</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Postural Exercise</intervention_name>
    <description>Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
    <arm_group_label>Pulmonary rehabilitation+exercise group</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          1. Be diagnosed with KF&#xD;
&#xD;
          2. Be able to understand commands&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          1. FEV1 below than %30&#xD;
&#xD;
          2. Cor pulmonale&#xD;
&#xD;
          3. Advanced gastroesophageal reflux&#xD;
&#xD;
          4. Current hospital admission due to lung infection&#xD;
&#xD;
          5. Be diagnosed with neuromuscular disease&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>6 Years</minimum_age>
    <maximum_age>14 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Evrim Karadag Saygi, MD, Prof</last_name>
    <role>Study Director</role>
    <affiliation>Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation</name>
      <address>
        <city>İstanbul</city>
        <zip>34899</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Turkey</country>
  </location_countries>
  <reference>
    <citation>Edwards J, Clarke A, Greenop D. Adults with cystic fibrosis - responding to a new ageing population. Chronic Illn. 2013 Dec;9(4):312-9. doi: 10.1177/1742395313479982. Epub 2013 May 23.</citation>
    <PMID>23702786</PMID>
  </reference>
  <reference>
    <citation>Barker N, Raghavan A, Buttling P, Douros K, Everard ML. Thoracic Kyphosis is Now Uncommon Amongst Children and Adolescents with Cystic Fibrosis. Front Pediatr. 2014 Feb 17;2:11. doi: 10.3389/fped.2014.00011. eCollection 2014.</citation>
    <PMID>24596827</PMID>
  </reference>
  <reference>
    <citation>Tattersall R, Walshaw MJ. Posture and cystic fibrosis. J R Soc Med. 2003;96 Suppl 43(Suppl 43):18-22. No abstract available.</citation>
    <PMID>12906321</PMID>
  </reference>
  <reference>
    <citation>Daniels T. Physiotherapeutic management strategies for the treatment of cystic fibrosis in adults. J Multidiscip Healthc. 2010 Nov 19;3:201-12. doi: 10.2147/JMDH.S8878.</citation>
    <PMID>21289861</PMID>
  </reference>
  <reference>
    <citation>Massery M. Musculoskeletal and neuromuscular interventions: a physical approach to cystic fibrosis. J R Soc Med. 2005;98 Suppl 45(Suppl 45):55-66.</citation>
    <PMID>16025768</PMID>
  </reference>
  <verification_date>January 2018</verification_date>
  <study_first_submitted>August 23, 2017</study_first_submitted>
  <study_first_submitted_qc>September 22, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">September 27, 2017</study_first_posted>
  <results_first_submitted>October 24, 2017</results_first_submitted>
  <results_first_submitted_qc>January 25, 2018</results_first_submitted_qc>
  <results_first_posted type="Actual">October 26, 2018</results_first_posted>
  <last_update_submitted>January 25, 2018</last_update_submitted>
  <last_update_submitted_qc>January 25, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">October 26, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Cystic Fibrosis</keyword>
  <keyword>Postural exercise</keyword>
  <keyword>Pulmonary rehabilitation</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Cystic Fibrosis</mesh_term>
    <mesh_term>Fibrosis</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Study Protocol and Statistical Analysis Plan</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>Yes</document_has_sap>
      <document_date>January 24, 2017</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/01/NCT03295201/Prot_SAP_000.pdf</document_url>
    </provided_document>
  </provided_document_section>

  <clinical_results>

    <participant_flow>
      <recruitment_details>Recruitment period was March 2017-October 2017 Setting: A university hospital outpatient clinics</recruitment_details>
      <pre_assignment_details>Number of patients assessed for eligibility was 30. Among them,8 participants were excluded due to being inappropiate for the inclusion criteria (6 were out of age limits, 2 did not agree to participate in the study)</pre_assignment_details>
      <group_list>
        <group group_id="P1">
          <title>Pulmonary Rehabilitation+Exercise Group</title>
          <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
        </group>
        <group group_id="P2">
          <title>Pulmonary Rehabilitation Group</title>
          <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
        </group>
      </group_list>
      <period_list>
        <period>
          <title>Overall Study</title>
          <milestone_list>
            <milestone>
              <title>STARTED</title>
              <participants_list>
                <participants group_id="P1" count="11"/>
                <participants group_id="P2" count="11"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="10"/>
                <participants group_id="P2" count="9"/>
              </participants_list>
            </milestone>
            <milestone>
              <title>NOT COMPLETED</title>
              <participants_list>
                <participants group_id="P1" count="1"/>
                <participants group_id="P2" count="2"/>
              </participants_list>
            </milestone>
          </milestone_list>
          <drop_withdraw_reason_list>
            <drop_withdraw_reason>
              <title>Lost to Follow-up</title>
              <participants_list>
                <participants group_id="P1" count="1"/>
                <participants group_id="P2" count="1"/>
              </participants_list>
            </drop_withdraw_reason>
            <drop_withdraw_reason>
              <title>Hospital admission</title>
              <participants_list>
                <participants group_id="P1" count="0"/>
                <participants group_id="P2" count="1"/>
              </participants_list>
            </drop_withdraw_reason>
          </drop_withdraw_reason_list>
        </period>
      </period_list>
    </participant_flow>

    <baseline>
      <group_list>
        <group group_id="B1">
          <title>Pulmonary Rehabilitation+Exercise Group</title>
          <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
        </group>
        <group group_id="B2">
          <title>Pulmonary Rehabilitation Group</title>
          <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
        </group>
        <group group_id="B3">
          <title>Total</title>
          <description>Total of all reporting groups</description>
        </group>
      </group_list>
      <analyzed_list>
        <analyzed>
          <units>Participants</units>
          <scope>Overall</scope>
          <count_list>
            <count group_id="B1" value="10"/>
            <count group_id="B2" value="9"/>
            <count group_id="B3" value="19"/>
          </count_list>
        </analyzed>
      </analyzed_list>
      <measure_list>
        <measure>
          <title>Age</title>
          <units>years</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="B1" value="10"/>
                    <count group_id="B2" value="9"/>
                    <count group_id="B3" value="19"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="9" spread="2"/>
                    <measurement group_id="B2" value="10" spread="3"/>
                    <measurement group_id="B3" value="9" spread="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Sex: Female, Male</title>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="B1" value="10"/>
                    <count group_id="B2" value="9"/>
                    <count group_id="B3" value="19"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <title>Female</title>
                  <measurement_list>
                    <measurement group_id="B1" value="3"/>
                    <measurement group_id="B2" value="4"/>
                    <measurement group_id="B3" value="7"/>
                  </measurement_list>
                </category>
                <category>
                  <title>Male</title>
                  <measurement_list>
                    <measurement group_id="B1" value="7"/>
                    <measurement group_id="B2" value="5"/>
                    <measurement group_id="B3" value="12"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Race and Ethnicity Not Collected</title>
          <population>Race and Ethnicity were not collected from any participant.</population>
          <units>Participants</units>
          <param>Count of Participants</param>
          <class_list>
            <class>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="B1" value="0"/>
                    <count group_id="B2" value="0"/>
                    <count group_id="B3" value="0"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B3" value="0"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Region of Enrollment</title>
          <units>participants</units>
          <param>Number</param>
          <class_list>
            <class>
              <title>Turkey</title>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="B1" value="10"/>
                    <count group_id="B2" value="9"/>
                    <count group_id="B3" value="19"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="10"/>
                    <measurement group_id="B2" value="9"/>
                    <measurement group_id="B3" value="19"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
        <measure>
          <title>Body Mass Index</title>
          <units>kg/m^2</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <class_list>
            <class>
              <analyzed_list>
                <analyzed>
                  <units>Participants</units>
                  <scope>Class</scope>
                  <count_list>
                    <count group_id="B1" value="10"/>
                    <count group_id="B2" value="9"/>
                    <count group_id="B3" value="19"/>
                  </count_list>
                </analyzed>
              </analyzed_list>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="B1" value="16" spread="2"/>
                    <measurement group_id="B2" value="16" spread="2"/>
                    <measurement group_id="B3" value="16" spread="2"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </measure_list>
    </baseline>

    <outcome_list>
      <outcome>
        <type>Primary</type>
        <title>Exercise Tolerance</title>
        <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
        <time_frame>Before treatment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Exercise Tolerance</title>
          <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
          <units>meters</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="817" spread="234.62"/>
                    <measurement group_id="O2" value="792.22" spread="327.21"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Exercise Tolerance</title>
        <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
        <time_frame>6 weeks</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Exercise Tolerance</title>
          <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
          <units>meters</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="980" spread="277.24"/>
                    <measurement group_id="O2" value="1058.77" spread="594.67"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Exercise Tolerance</title>
        <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Exercise Tolerance</title>
          <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
          <units>meters</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1104" spread="306.73"/>
                    <measurement group_id="O2" value="1036.66" spread="457.16"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Primary</type>
        <title>Exercise Tolerance</title>
        <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Exercise Tolerance</title>
          <description>Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.</description>
          <units>meters</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1251" spread="324.15"/>
                    <measurement group_id="O2" value="1161.11" spread="594.06"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Quality of Life</title>
        <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
        <time_frame>Before treatment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Quality of Life</title>
          <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="86.4" spread="5.75"/>
                    <measurement group_id="O2" value="92.77" spread="9.94"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Quality of Life</title>
        <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
        <time_frame>6 weeks</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Quality of Life</title>
          <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="88.9" spread="7.04"/>
                    <measurement group_id="O2" value="90.88" spread="13.37"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Quality of Life</title>
        <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Quality of Life</title>
          <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="87.2" spread="5.57"/>
                    <measurement group_id="O2" value="93.33" spread="11.35"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Quality of Life</title>
        <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Quality of Life</title>
          <description>The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.</description>
          <units>units on a scale</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="89.7" spread="7.84"/>
                    <measurement group_id="O2" value="95.55" spread="12.64"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Postural Stability</title>
        <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
        <time_frame>Before treatment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Postural Stability</title>
          <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
          <units>seconds</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.29" spread="0.85"/>
                    <measurement group_id="O2" value="1.03" spread="0.53"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Postural Stability</title>
        <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
        <time_frame>6 weeks</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Postural Stability</title>
          <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
          <units>seconds</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.91" spread="0.66"/>
                    <measurement group_id="O2" value="0.83" spread="0.65"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Postural Stability</title>
        <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Postural Stability</title>
          <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
          <units>seconds</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="0.88" spread="0.72"/>
                    <measurement group_id="O2" value="0.65" spread="0.52"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Postural Stability</title>
        <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Postural Stability</title>
          <description>The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.</description>
          <units>seconds</units>
          <param>Mean</param>
          <dispersion>Standard Error</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="1.15" spread="0.69"/>
                    <measurement group_id="O2" value="0.92" spread="0.46"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Pulmonary Function</title>
        <description>Forced expiratory volume in 1 second (FEV1)</description>
        <time_frame>Before treatment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Pulmonary Function</title>
          <description>Forced expiratory volume in 1 second (FEV1)</description>
          <units>millilitres</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="82.8" spread="14.57"/>
                    <measurement group_id="O2" value="83.78" spread="21.06"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Pulmonary Function</title>
        <description>Forced expiratory volume in 1 second (FEV1)</description>
        <time_frame>6 weeks</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Pulmonary Function</title>
          <description>Forced expiratory volume in 1 second (FEV1)</description>
          <units>millilitres</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="93.3" spread="21.71"/>
                    <measurement group_id="O2" value="82.11" spread="17.14"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Pulmonary Function</title>
        <description>Forced expiratory volume in 1 second (FEV1)</description>
        <time_frame>3 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Pulmonary Function</title>
          <description>Forced expiratory volume in 1 second (FEV1)</description>
          <units>millilitres</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="86.6" spread="12.19"/>
                    <measurement group_id="O2" value="82.77" spread="17.85"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Pulmonary Function</title>
        <description>Forced expiratory volume in 1 second (FEV1)</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Pulmonary Function</title>
          <description>Forced expiratory volume in 1 second (FEV1)</description>
          <units>millilitres</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="87.7" spread="16.95"/>
                    <measurement group_id="O2" value="90" spread="23.52"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Spinal Deformity- The Cobb Angle (Researcher 1)</title>
        <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
        <time_frame>Before treatment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Spinal Deformity- The Cobb Angle (Researcher 1)</title>
          <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
          <units>degrees</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.37" spread="1.40"/>
                    <measurement group_id="O2" value="7.75" spread="5.95"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Spinal Deformity- The Cobb Angle (Researcher 2)</title>
        <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
        <time_frame>Before treatment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Spinal Deformity- The Cobb Angle (Researcher 2)</title>
          <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
          <units>degrees</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="2.12" spread="2.1"/>
                    <measurement group_id="O2" value="7.75" spread="5.12"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Spinal Deformity- The Cobb Angle (Researcher 1)</title>
        <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Spinal Deformity- The Cobb Angle (Researcher 1)</title>
          <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
          <units>degrees</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.5" spread="2.56"/>
                    <measurement group_id="O2" value="5.25" spread="3.41"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Spinal Deformity- The Cobb Angle (Researcher 2)</title>
        <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Spinal Deformity- The Cobb Angle (Researcher 2)</title>
          <description>The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.</description>
          <units>degrees</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="3.88" spread="2.42"/>
                    <measurement group_id="O2" value="5.5" spread="2.83"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Spinal Deformity- The Modified Cobb Angle (Researcher 1)</title>
        <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
        <time_frame>Before treatment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Spinal Deformity- The Modified Cobb Angle (Researcher 1)</title>
          <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
          <units>degrees</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="35.33" spread="12.62"/>
                    <measurement group_id="O2" value="34.33" spread="6.84"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Spinal Deformity- The Modified Cobb Angle (Researcher 2)</title>
        <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
        <time_frame>Before treatment</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Spinal Deformity- The Modified Cobb Angle (Researcher 2)</title>
          <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
          <units>degrees</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="34.67" spread="11.76"/>
                    <measurement group_id="O2" value="33.11" spread="7.4"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Spinal Deformity- The Modified Cobb Angle (Researcher 1)</title>
        <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Spinal Deformity- The Modified Cobb Angle (Researcher 1)</title>
          <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
          <units>degrees</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="35.5" spread="8.09"/>
                    <measurement group_id="O2" value="32.33" spread="3.08"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
      <outcome>
        <type>Secondary</type>
        <title>Spinal Deformity- The Modified Cobb Angle (Researcher 2)</title>
        <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
        <time_frame>6 months</time_frame>
        <group_list>
          <group group_id="O1">
            <title>Pulmonary Rehabilitation+Exercise Group</title>
            <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
          </group>
          <group group_id="O2">
            <title>Pulmonary Rehabilitation Group</title>
            <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
          </group>
        </group_list>
        <measure>
          <title>Spinal Deformity- The Modified Cobb Angle (Researcher 2)</title>
          <description>The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.</description>
          <units>degrees</units>
          <param>Mean</param>
          <dispersion>Standard Deviation</dispersion>
          <analyzed_list>
            <analyzed>
              <units>Participants</units>
              <scope>Measure</scope>
              <count_list>
                <count group_id="O1" value="10"/>
                <count group_id="O2" value="9"/>
              </count_list>
            </analyzed>
          </analyzed_list>
          <class_list>
            <class>
              <category_list>
                <category>
                  <measurement_list>
                    <measurement group_id="O1" value="35" spread="7.87"/>
                    <measurement group_id="O2" value="32.4" spread="3.33"/>
                  </measurement_list>
                </category>
              </category_list>
            </class>
          </class_list>
        </measure>
      </outcome>
    </outcome_list>

    <reported_events>
      <time_frame>6 months</time_frame>
      <desc>All-Cause Mortality, Serious, or Other (non-serious) Adverse Events were monitored.</desc>
      <group_list>
        <group group_id="E1">
          <title>Pulmonary Rehabilitation+Exercise Group</title>
          <description>Active cycle of breathing techniques (ACBT) and postural exercise program&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.&#xD;
Postural Exercise: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.</description>
        </group>
        <group group_id="E2">
          <title>Pulmonary Rehabilitation Group</title>
          <description>Active cycle of breathing techniques (ACBT)&#xD;
Active cycle of breathing techniques (ACBT): ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.</description>
        </group>
      </group_list>
      <serious_events>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, all-cause mortality</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="10"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="9"/>
              </event>
              <event>
                <sub_title>Total, serious adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="10"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="9"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </serious_events>
      <other_events>
        <frequency_threshold>0</frequency_threshold>
        <category_list>
          <category>
            <title>Total</title>
            <event_list>
              <event>
                <sub_title>Total, other adverse events</sub_title>
                <counts group_id="E1" subjects_affected="0" subjects_at_risk="10"/>
                <counts group_id="E2" subjects_affected="0" subjects_at_risk="9"/>
              </event>
            </event_list>
          </category>
        </category_list>
      </other_events>
    </reported_events>

    <certain_agreements>
      <pi_employee>Principal Investigators are NOT employed by the organization sponsoring the study.</pi_employee>
      <restrictive_agreement>There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed. </restrictive_agreement>
    </certain_agreements>
    <point_of_contact>
      <name_or_title>Dr. Kardelen Gencer Atalay</name_or_title>
      <organization>Marmara University</organization>
      <phone>5324404887 ext 532</phone>
      <email>kardelengencer@gmail.com</email>
    </point_of_contact>
  </clinical_results>
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03295201
org study id: 09.2015.287
nct id: NCT03295201
lead sponsor: 
is fda regulated drug: No
is fda regulated device: No
The aim of this study is to investigate the effects of postural exercise program added to
      pulmonary rehabilitation program on quality of life, exercise tolerance and postural
      stability in children with Cystic Fibrosis.
Cystic fibrosis (CF) is an autosomal recessive, multisystem involvement disease. The most
      important cause of mortality in CF is pulmonary complications. Prevention of pulmonary
      complications is only possible with pulmonary rehabilitation. Pulmonary rehabilitation
      methods used in CF are called airway cleaning techniques that include postural drainage,
      breathing techniques and use of devices. These techniques have not been proven to be superior
      to each other. Active cycle of breathing techniques (ACBT) is one of the breathing techniques
      used to remove secretions from the lungs.

      Pulmonary disease progression in CF causes postural impairment and decrease of exercise
      tolerance, which can reduce effectiveness of pulmonary rehabilitation. The aim of this study
      is to investigate the effects of postural exercise program added to pulmonary rehabilitation
      program on quality of life, exercise tolerance and postural stability in children with CF.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Triple (Participant, Care Provider, Outcomes Assessor)
measure: Exercise Tolerance
time frame: Before treatment
description: Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.
measure: Exercise Tolerance
time frame: 6 weeks
description: Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.
measure: Exercise Tolerance
time frame: 3 months
description: Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.
measure: Exercise Tolerance
time frame: 6 months
description: Modified Shuttle Test (MST) is used to measure the exercise tolerance. The patient is asked to walk until feeling tired between two fixed objects with a 10-meter interval, starting at normal walking speed and increasing the speed at the beginning of each minute. Maximum distance (meters) is measured for the test.
measure: Quality of Life
time frame: Before treatment
description: The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.
measure: Quality of Life
time frame: 6 weeks
description: The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.
measure: Quality of Life
time frame: 3 months
description: The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.
measure: Quality of Life
time frame: 6 months
description: The Cystic Fibrosis Questionnaire-Revised (CFQR) is used to measure the quality of life. This scale is found to be valid and reliable in Turkish. The child version of this test consists 35 questions about physical function, emotional function, social function, body appearance, eating disorders, treatment difficulties, respiratory and digestive symptoms. The total score is calculated between 0-100 and higher scores define the better condition.
measure: Postural Stability
time frame: Before treatment
description: The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.
measure: Postural Stability
time frame: 6 weeks
description: The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.
measure: Postural Stability
time frame: 3 months
description: The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.
measure: Postural Stability
time frame: 6 months
description: The Balance Master Device- Limits of Stability Test (LOS) is used for to measure the postural stability of children. The LOS consists a 18x60 inch of a pressure platform which connected to a computer system. The patient is asked to stand on the platform barefoot and watch the image which can be moved by trunk movement on the computer the monitor. It is required to move the image towards to target points on the monitor with commands. Reaction time, movement velocity, endpoint excursion, maximum excursion and direction control parameters are calculated during these trunk movements. Reaction time (seconds) parameter is preferred to use for this study.
measure: Pulmonary Function
time frame: Before treatment
description: Forced expiratory volume in 1 second (FEV1)
measure: Pulmonary Function
time frame: 6 weeks
description: Forced expiratory volume in 1 second (FEV1)
measure: Pulmonary Function
time frame: 3 months
description: Forced expiratory volume in 1 second (FEV1)
measure: Pulmonary Function
time frame: 6 months
description: Forced expiratory volume in 1 second (FEV1)
measure: Spinal Deformity- The Cobb Angle (Researcher 1)
time frame: Before treatment
description: The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.
measure: Spinal Deformity- The Cobb Angle (Researcher 2)
time frame: Before treatment
description: The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.
measure: Spinal Deformity- The Cobb Angle (Researcher 1)
time frame: 6 months
description: The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.
measure: Spinal Deformity- The Cobb Angle (Researcher 2)
time frame: 6 months
description: The Cobb angle was measured on anteroposterior scoliosis graphs by the angle between the superior end plate of the vertebra corpus where the curve begins and the end plate of the vertebra corpus which the curve ends.
measure: Spinal Deformity- The Modified Cobb Angle (Researcher 1)
time frame: Before treatment
description: The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.
measure: Spinal Deformity- The Modified Cobb Angle (Researcher 2)
time frame: Before treatment
description: The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.
measure: Spinal Deformity- The Modified Cobb Angle (Researcher 1)
time frame: 6 months
description: The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.
measure: Spinal Deformity- The Modified Cobb Angle (Researcher 2)
time frame: 6 months
description: The Modified Cobb angle was found on lateral scoliosis graphs by the angle between the superior end plate of the T4 vertebra corpus and the inferior end plate of the T12 vertebra corpus.
arm group label: Pulmonary rehabilitation+exercise group
arm group type: Experimental
description: Active cycle of breathing techniques (ACBT) and postural exercise program
arm group label: Pulmonary rehabilitation group
arm group type: Active Comparator
description: Active cycle of breathing techniques (ACBT)
intervention type: Other
intervention name: Active cycle of breathing techniques (ACBT)
description: ACBT involves three phases (Breathing control, chest expansion exercise, and huff coughing). These phases will apply with a sequence to remove secretion. ACBT will apply 1 per a week for 6 weeks.
arm group label: Pulmonary rehabilitation group
arm group label: Pulmonary rehabilitation+exercise group
intervention type: Other
intervention name: Postural Exercise
description: Postural exercise program will include thoracic vertebra mobilization, pectoral stretching, scapula and thoracic extensors strengthening and core stability exercises. Postural exercise program will apply 1 per a week for 6 weeks.
arm group label: Pulmonary rehabilitation+exercise group
criteria: 
gender: All
minimum age: 6 Years
maximum age: 14 Years
healthy volunteers: No
last name: Evrim Karadag Saygi, MD, Prof
role: Study Director
affiliation: Marmara University School of Medicine, Department of Physical Medicine and Rehabilitation
facility: 
country: Turkey
citation: Edwards J, Clarke A, Greenop D. Adults with cystic fibrosis - responding to a new ageing population. Chronic Illn. 2013 Dec;9(4):312-9. doi: 10.1177/1742395313479982. Epub 2013 May 23.
PMID: 23702786
citation: Barker N, Raghavan A, Buttling P, Douros K, Everard ML. Thoracic Kyphosis is Now Uncommon Amongst Children and Adolescents with Cystic Fibrosis. Front Pediatr. 2014 Feb 17;2:11. doi: 10.3389/fped.2014.00011. eCollection 2014.
PMID: 24596827
citation: Tattersall R, Walshaw MJ. Posture and cystic fibrosis. J R Soc Med. 2003;96 Suppl 43(Suppl 43):18-22. No abstract available.
PMID: 12906321
citation: Daniels T. Physiotherapeutic management strategies for the treatment of cystic fibrosis in adults. J Multidiscip Healthc. 2010 Nov 19;3:201-12. doi: 10.2147/JMDH.S8878.
PMID: 21289861
citation: Massery M. Musculoskeletal and neuromuscular interventions: a physical approach to cystic fibrosis. J R Soc Med. 2005;98 Suppl 45(Suppl 45):55-66.
PMID: 16025768
responsible party type: Sponsor
mesh term: Cystic Fibrosis
mesh term: Fibrosis
sharing ipd: No
provided document: 
participant flow: 
baseline: 
outcome list: 
reported events: 
certain agreements: 
point of contact: 