Physical training for bronchiectasis

A search for controlled trials of physical training in bronchiectasis only identified two early reports (abstracts) including 43 patients in total. These suggest some benefits of inspiratory muscle training on exercise capacity, quality of life and respiratory muscle function at eight weeks, but further research is needed to confirm these findings in larger numbers of people with bronchiectasis. Further research is also needed to assess the benefit of other types of physical training and pulmonary rehabilitation in bronchiectasis.

Authors' conclusions: 

This review only provides evidence of the benefits of inspiratory muscle training and provides no evidence of the effect of other types of physical training (including pulmonary rehabilitation) in bronchiectasis.

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Background: 

The pathophysiology of bronchiectasis may result in the development of dyspnoea and decreased exercise tolerance, both of which can impact on a patient's quality of life and ability to perform activities of daily living. There is little information regarding the benefits of physical training in bronchiectasis: however it is probable that the benefits of physical training in bronchiectasis are at least comparable to benefits demonstrated in other respiratory conditions. There is also no information regarding the effects of non-adherence to prescribed physical training in bronchiectasis. However as in patients with COPD non-adherence may contribute to a deterioration in the patient's condition and conceivably the long term prognosis.

Objectives: 

The objective of this review is to determine whether a prescribed regime of physical training produces improvements or prevents deterioration in physiological and clinical outcomes in bronchiectasis compared to no physical training.

Search strategy: 

We searched the Cochrane Airways Group trials register and the Cochrane Central Register of Controlled Trials.

Selection criteria: 

Randomised or quasi randomised controlled trials in which a prescribed regimen of physical training is compared to no physical training in patients with bronchiectasis.

Data collection and analysis: 

We identified three studies. One was did not meet the inclusion criteria and two appeared in abstract form only. More comprehensive data will be incorporated into this review once data from those two trials are published, and when further data is made available to the authors of this review. An update search in February 2005 identified one excluded study.

Main results: 

Results from the two studies published in abstract showed that inspiratory muscle training compared to sham or no inspiratory muscle training improved endurance exercise capacity: Weighted Mean Difference (WMD) 264 metres (95% CI 16.4 to 512 metres). Maximum inspiratory pressure (PiMax) improved: WMD 25 cms H20 (95% CI 11.6 to 38.4 cms H2O ) as did quality of life measured with the CRQ: WMD 12.4 units (95% CI 2.4 to 22.5 units).

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