This randomized clinical trial aims to evaluate the effects of high-frequency chest wall oscillation (HFCWO) combined with concurrent training on cough, sputum clearance, exercise tolerance, and respiratory muscle strength in patients with Cystic Fibrosis. A total of 24 participants meeting inclusion criteria will be randomly allocated into two groups: Group A will receive HFCWO plus concurrent training, while Group B will receive HFCWO alone for 8 weeks. Outcomes will be measured before and after intervention using the 6-minute walk test, spirometry, Leicester Cough Questionnaire, sputum volume, and the Cystic Fibrosis Questionnaire-Revised. The study will be conducted at Pulmonary Rehabilitation Unit, Gulab Devi Hospital and Mayo Hospital, Lahore. Statistical analysis will be performed using IBM SPSS Statistics, with significance set at p < 0.05.

This randomized clinical trial will evaluate the effects of high-frequency chest wall oscillation (HFCWO) combined with concurrent training on cough, sputum clearance, exercise tolerance, respiratory muscle strength, and quality of life in patients with Cystic Fibrosis. Cystic fibrosis causes thick mucus accumulation in the lungs, leading to chronic infections, airway obstruction, and reduced pulmonary function.

A total of 24 participants will be recruited and randomly divided into two groups. Group A will receive HFCWO combined with aerobic and resistance training, while Group B will receive HFCWO alone for 8 weeks. HFCWO will be applied using the SmartVest/Monarch system for 20 minutes per session, while concurrent training will include treadmill walking and resistance exercises.

Outcome measures will be assessed before and after treatment using the 6-minute walk test, spirometry, Leicester Cough Questionnaire, sputum volume, and the Cystic Fibrosis Questionnaire-Revised. The study will be conducted at Gulab Devi Hospital and Mayo Hospital, and data will be analyzed using IBM SPSS Statistics with significance set at p < 0.05

Inclusion Criteria:

• Diagnosed with Cystic Fibrosis, confirmed by genotype or sweat chloride >60 mmol/L.
• Age 16-35 years.
• Both male and female participants.
• Stable clinical condition (no exacerbations in the last 2 weeks).
• Forced expiratory volume in 1 second (FEV₁ ≥ 20% predicted).

Exclusion Criteria:

• Active hemoptysis or pneumothorax.
• Risk of hemodynamic instability or severe hypoxia.
• Acute airway infection.
• Cognitive disorders affecting compliance.
• Pregnancy.
• Cardiac diseases such as heart failure or arrhythmias.
• Neurological or orthopedic illnesses or recent chest injury.

Because of the physical nature of the interventions, both participants and investigators will know which treatment is being given. No blinding will be applied.