Journal Article

The short and long term effects of exercise training in non-cystic fibrosis bronchiectasis – a randomised controlled trial

Burge, Angela T, McDonald, Christine F, Jenkins, Sue, Rautela, Linda, Stirling, Robert G, Cecins, Nola, Thompson, Philip J, Hill, Catherine J, Lee, Annemarie L, Holland, Anne E

2014

Overview

Background Exercise training is recommended for non-cystic fibrosis (CF) bronchiectasis, but the long-term effects are unclear. This randomised controlled trial aimed to determine the effects of exercise training and review of airway clearance therapy (ACT) on exercise capacity, health related quality of life (HRQOL) and the incidence of acute exacerbations in people with non-CF bronchiectasis. Methods Participants were randomly allocated to 8 weeks of supervised exercise training and review of ACT, or control. Primary outcomes of exercise capacity and HRQOL (Chronic respiratory disease questionnaire) and secondary outcomes of cough-related QOL (Leicester cough questionnaire) and psychological symptoms (Hospital anxiety and depression scale) were measured at baseline, following completion of the intervention period and at 6 and 12 months follow up. Secondary outcomes of the exacerbation rate and time to first exacerbation were analysed over 12 months. Results Eighty-five participants (mean FEV 1 74% predicted; median Modified Medical Research Council Dyspnoea grade of 1 (IQR [1–3]) were included. Exercise training increased the incremental shuttle walk distance (mean difference to control 62 m, 95% CI 24 to 101 m) and the 6-minute walking distance (mean difference to control 41 m, 95% CI 19 to 63 m), but these improvements were not sustained at 6 or 12 months. Exercise training reduced dyspnoea (p = 0.009) and fatigue (p = 0.01) but did not impact on cough-related QOL or mood. Exercise training reduced the frequency of acute exacerbations (median 1[IQR 1–3]) compared to the control group (2[1–3]) over 12 months follow up (p = 0.012), with a longer time to first exacerbation with exercise training of 8 months (95% CI 7 to 9 months) compared to the control group (6 months [95% CI 5 to 7 months], p = 0.047). Conclusions Exercise training in bronchiectasis is associated with short term improvement in exercise capacity, dyspnoea and fatigue and fewer exacerbations over 12 months. Trial registry ClinicalTrials.gov ( NCT00885521 ).

• Publisher: BioMed Central,BioMed Central Ltd,Nature Publishing Group
• Subject: Aged / Anxiety / Asthma / Bronchiectasis - diagnosis / Bronchiectasis - psychology / Bronchiectasis - therapy / Chronic obstructive pulmonary disease / Complications and side effects / Cystic Fibrosis / Depression, Mental / Development and progression / Exercise / Exercise - physiology / Exercise - psychology / Exercise Therapy - methods / Exercise Therapy - psychology / Exercise Therapy - trends / Fatigue / Female / Follow-Up Studies / Hospitals / Humans / Intervention / Lung diseases / Male / Medical research / Medicine / Medicine & Public Health / Middle Aged / Patient outcomes / Physical fitness / Physical training / Pneumology/Respiratory System / Prospective Studies / Quality of life / Quality of Life - psychology / Rehabilitation / Respiratory diseases / Risk factors / Single-Blind Method / Sports training / Studies / Time Factors / Tomography / Treatment Outcome