A pilot study of pulmonary rehabilitation and chest physiotherapy versus chest physiotherapy alone in bronchiectasis

Mandal, Pallavi; Sidhu, M.; Kope, L.; Pollock, Wendy; Stevenson, L.; Pentland, J L; Turnbull, Kim; Quarrie, S. Mac; Hill, Adam T.

doi:10.1016/j.rmed.2012.08.004

Cited by 92 publications

(95 citation statements)

References 25 publications

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“…ESWT is responsive to pulmonary rehabilitation in patients with COPD (the pooled mean of studies in figure 9 is ∼360 s), bronchiectasis [203] and IPF [175] (table 3). ESWT is also responsive to oxygen therapy in patients with COPD [204] and IPF [175] who desaturate during exercise.…”

Section: Discussionmentioning

confidence: 99%

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

et al. 2016

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This document reviews 1) the measurement properties of commonly used exercise tests in patients with chronic respiratory diseases and 2) published studies on their utilty and/or evaluation obtained from MEDLINE and Cochrane Library searches between 1990 and March 2015.Exercise tests are reliable and consistently responsive to rehabilitative and pharmacological interventions. Thresholds for clinically important changes in performance are available for several tests. In pulmonary arterial hypertension, the 6-min walk test (6MWT), peak oxygen uptake and ventilation/carbon dioxide output indices appear to be the variables most responsive to vasodilators. While bronchodilators do not always show clinically relevant effects in chronic obstructive pulmonary disease, high-intensity constant work-rate (endurance) tests (CWRET) are considerably more responsive than incremental exercise tests and 6MWTs. High-intensity CWRETs need to be standardised to reduce interindividual variability. Additional physiological information and responsiveness can be obtained from isotime measurements, particularly of inspiratory capacity and dyspnoea. Less evidence is available for the endurance shuttle walk test. Although the incremental shuttle walk test and 6MWT are reliable and less expensive than cardiopulmonary exercise testing, two repetitions are needed at baseline. All exercise tests are safe when recommended precautions are followed, with evidence suggesting that no test is safer than others. @ERSpublications A review of exercise testing to evaluate interventions aimed to improve exercise tolerance in respiratory patients

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Section: Discussionmentioning

confidence: 99%

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

et al. 2016

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“…In a retrospective study, ONG et al [48] studied 95 patients with bronchiectasis, demonstrating a mean improvement in 6-min walk distance of 53 m which was sustained to 12 months (difference at 12 months 20.5 m) . A subsequent pilot randomised controlled trial showed improvements in LCQ and SGRQ sustained to 20 weeks after treatment [49]. In a recent randomised controlled trial by LEE et al [50], an 8-week supervised exercise training schedule that include airway-clearance techniques was compared with standard care .…”

Section: Airway Clearancementioning

confidence: 99%

Management of bronchiectasis in adults

2015

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Formerly regarded as a rare disease, bronchiectasis is now increasingly recognised and a renewed interest in the condition is stimulating drug development and clinical research. Bronchiectasis represents the final common pathway of a number of infectious, genetic, autoimmune, developmental and allergic disorders and is highly heterogeneous in its aetiology, impact and prognosis.The goals of therapy should be: to improve airway mucus clearance through physiotherapy with or without adjunctive therapies; to suppress, eradicate and prevent airway bacterial colonisation; to reduce airway inflammation; and to improve physical functioning and quality of life.Fortunately, an increasing body of evidence supports interventions in bronchiectasis. The field has benefited greatly from the introduction of evidence-based guidelines in some European countries and randomised controlled trials have now demonstrated the benefit of long-term macrolide therapy, with accumulating evidence for inhaled therapies, physiotherapy and pulmonary rehabilitation.This review provides a critical update on the management of bronchiectasis focussing on emerging evidence and recent randomised controlled trials. @ERSpublications Bronchiectasis is a rapidly developing field: review of recent RCTs and progress towards developing new therapies

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“…Although few studies have explored the impact of physiotherapy in bronchiectasis, airway clearance techniques seem to be safe and allow a better sputum expectoration with an increase in patients' quality of life [20]. Evidence on pulmonary rehabilitation is scarce; however, most of the studies demonstrated an increase in patients' performance and quality of life, and an increase of the time to the next exacerbation [21][22][23]. Both physicians and patients agreed that additional controlled trials of these interventions would be beneficial but that the priority may be in identifying methods that are accessible and that encourage adherence.…”

Section: Consensus Statementmentioning

confidence: 99%

“…>96% of respondents felt that their bronchiectasis could be better managed through having a self-management plan co-designed with their HCP, and access to physiotherapy/pulmonary rehabilitation, which also includes teaching them how to use techniques/equipment at home [1,22,40,68,69]. Self-management plans facilitated by good communication between patients and HCPs empower patients to manage and cope with their condition more confidently and independently [70,71].…”

Section: Condition Managementmentioning

confidence: 99%

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

et al. 2016

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Bronchiectasis is a disease of renewed interest in light of an increase in prevalence and increasing burden on international healthcare systems. There are no licensed therapies, and large gaps in knowledge in terms of epidemiology, pathophysiology and therapy. The European Multicentre Bronchiectasis Audit and Research Collaboration (EMBARC) is a European Respiratory Society (ERS) Clinical Research Collaboration, funded by ERS to promote high-quality research in bronchiectasis. The objective of this consensus statement was to define research priorities in bronchiectasis. From 2014 to 2015, EMBARC used a modified Delphi process among European bronchiectasis experts to reach a consensus on 55 key research priorities in this field. During the same period, the European Lung Foundation collected 711 questionnaires from adult patients with bronchiectasis and their carers from 22 European countries reporting important research priorities from their perspective. This consensus statement reports recommendations for bronchiectasis research after integrating both physicians and patients priorities, as well as those uniquely identified by the two groups. Priorities identified in this consensus statement provide the clearest possible roadmap towards improving our understanding of the disease and the quality of care for patients with bronchiectasis. @ERSpublications EMBARC consensus statement identifies research priorities in bronchiectasis as determined by physicians and patients

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A pilot study of pulmonary rehabilitation and chest physiotherapy versus chest physiotherapy alone in bronchiectasis

Abstract: Pulmonary rehabilitation in addition to regular chest physiotherapy, improves exercise tolerance and health related quality of life in non cystic fibrosis bronchiectasis and the benefit was sustained at 12 weeks post end of pulmonary rehabilitation. Clinical trials regn no. NCT00868075.

Cited by 92 publications

References 25 publications

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

Management of bronchiectasis in adults

Research priorities in bronchiectasis: a consensus statement from the EMBARC Clinical Research Collaboration

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