{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T03:25:18Z","timestamp":1775273118078,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Question<\/jats:title>\n                    <jats:p>Cystic fibrosis (CF) affects &gt;\u200911,300 people in the UK and is characterized by thick, sticky mucus in the lungs, leading to recurrent infections, inflammation, and progressive respiratory decline. Chest physiotherapy remains a cornerstone of airway clearance; however, many people with CF (pwCF) find it burdensome and time\u2010consuming. Exercise has been proposed as a potentially effective and more acceptable alternative. The ExACT\u2010CF feasibility trial evaluated the use of exercise as an airway clearance technique in pwCF on modulator therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This nested qualitative study explored the experiences of participants and healthcare professionals involved in the ExACT\u2010CF trial, alongside broader perspectives on airway clearance, to inform future research and clinical practice. Purposively sampled semi\u2010structured interviews were conducted with 32 individuals: ten pwCF, five parents, twelve healthcare professionals, four decliners, and one participant who withdrew. Interviews were audio\u2010recorded, transcribed verbatim, and analyzed thematically using \u201cThe Framework Method.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two primary themes emerged. Theme 1 reflected experiences and lessons learned from the trial, including reported barriers and facilitators around recruitment, randomization, and daily implementation. Despite some minor difficulties, trial participation, processes, and the intervention itself were broadly acceptable. Theme 2 highlighted a preference for using ExACT alone or interchangeably with chest physiotherapy. Participants emphasized the need for robust clinical evidence to guide use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Answer<\/jats:title>\n                    <jats:p>This study highlights the acceptability of both the ExACT\u2010CF trial processes and the use of this exercise\u2010based airway clearance technique. Findings support progression to a definitive trial and further exzploration of patient\u2010centered, flexible approaches to airway clearance in CF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>NCT02429180.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71470","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T21:10:28Z","timestamp":1769461828000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring Exercise as Airway Clearance in Cystic Fibrosis: A Qualitative Study From the ExACT\u2010CF Feasibility Trial"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9541-785X","authenticated-orcid":false,"given":"Emily","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Child Life and Health University of Edinburgh  Edinburgh UK"},{"name":"Department of Paediatric Respiratory and Sleep Medicine Royal Hospital for Children and Young People  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dia","family":"Soilemezi","sequence":"additional","affiliation":[{"name":"Department of Psychology, Faculty of Science and Health University of Portsmouth  Portsmouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9048-9692","authenticated-orcid":false,"given":"Don S.","family":"Urquhart","sequence":"additional","affiliation":[{"name":"Department of Child Life and Health University of Edinburgh  Edinburgh UK"},{"name":"Department of Paediatric Respiratory and Sleep Medicine Royal Hospital for Children and Young People  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7342-251X","authenticated-orcid":false,"given":"Steve","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Child Life and Health University of Edinburgh  Edinburgh UK"},{"name":"Department of Paediatric Respiratory and Sleep Medicine Royal Hospital for Children and Young People  Edinburgh UK"},{"name":"Centre for Inflammation Research University of Edinburgh  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1210-2314","authenticated-orcid":false,"given":"Steff","family":"Lewis","sequence":"additional","affiliation":[{"name":"Usher Institute, Edinburgh Clinical Trials Unit, NINE Edinburgh Bioquarter University of Edinburgh  Edinburgh France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3758-0566","authenticated-orcid":false,"given":"Aileen Rae","family":"Neilson","sequence":"additional","affiliation":[{"name":"Usher Institute, Edinburgh Clinical Trials Unit, NINE Edinburgh Bioquarter University of Edinburgh  Edinburgh France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3052-7287","authenticated-orcid":false,"given":"Hannah","family":"Ensor","sequence":"additional","affiliation":[{"name":"Usher Institute, Edinburgh Clinical Trials Unit, NINE Edinburgh Bioquarter University of Edinburgh  Edinburgh France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4830-7207","authenticated-orcid":false,"given":"Ioannis","family":"Vogiatizis","sequence":"additional","affiliation":[{"name":"Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences Northumbria University  Newcastle upon Tyne UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorna","family":"Allen","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Trust, One Aldgate Second Floor  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0674-8477","authenticated-orcid":false,"given":"Zoe L.","family":"Saynor","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Faculty of Environmental and Life Sciences University of Southampton  Southampton UK"},{"name":"Wessex Cystic Fibrosis Unit University Hospitals Southampton NHS Foundation Trust  Southampton UK"},{"name":"National Institute for Health and Care Research, Southampton Biomedical Research Centre University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the ExACT\u2010CF study 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