Upper Extremity Exercise Capacity and Activities of Daily Living in Individuals with Bronchiectasis Versus Healthy Controls

Abstract

Objective The purpose of this study was to compare the upper extremity exercise capacity and activities of daily living (ADLs) in individuals with bronchiectasis and controls. Methods Twenty-four individuals with bronchiectasis and 24 healthy controls were assessed for upper extremity exercise capacity (6-minute pegboard and ring test [6PBRT]) and ADLs (Glittre ADL test). Energy expenditure was measured using a wearable metabolic monitor during the Glittre ADL test. Results The mean 6PBRT score of individuals with bronchiectasis was significantly lower than the mean score of controls (196.50 [SD = 51.75] versus 243.00 [SD = 29.76] number of rings). The Glittre ADL test duration was significantly higher in individuals with bronchiectasis compared with controls (3.54 [SD = 1.53] versus 2.36 [SD = 0.18] min), despite similar energy expenditure during the Glittre ADL test between the groups (17.67 [SD = 5.28] kcal in individuals with bronchiectasis versus 18.13 [SD = 5.71] kcal in controls). The 6PBRT score and the Glittre ADL test duration were negatively correlated in individuals with bronchiectasis (r = −0.694). Conclusions The individuals with bronchiectasis had reduced upper extremity exercise capacity compared with healthy controls. Energy expenditure during ADLs was similar between individuals with bronchiectasis and healthy controls, despite lower ADL performance in individuals with bronchiectasis. The upper extremity exercise capacity and ADLs are related in individuals with bronchiectasis. Given the relationship between upper extremity exercise capacity and ADLs in bronchiectasis, inclusion of upper extremity exercise training to pulmonary rehabilitation programs should be considered. Impact Considering the impairment of upper extremity exercise capacity and ADLs in individuals with bronchiectasis highlights the necessity to tailor preventive strategies and preclude further unfavorable effects. Lay Summary Bronchiectasis may cause deterioration in upper extremity exercise capacity and ADLs. The assessment of upper exercise capacity and ADLs by physical therapists in individuals with bronchiectasis may be useful for designing comprehensive rehabilitation programs and thus the management of bronchiectasis.

Evaluating the contribution of the Glittre‐ADL test in adults with cystic fibrosis

“…This causes them to fail at upper extremity exercises at low workloads (Cakmak et al, 2023). In the present study, we observed that the median TGlittre time in CF patients was 3.17 min, well above that observed in CG patients.…”

“…Since the muscles that move the arm are attached to the rib cage, they stabilize the trunk but considerably increase the resistance of the chest wall in CF, limiting the ability to increase tidal volume during arm activities. This causes them to fail at upper extremity exercises at low workloads (Cakmak et al., 2023). In the present study, we observed that the median TGlittre time in CF patients was 3.17 min, well above that observed in CG patients.…”

“…In CF, muscle strength may also decrease with disease progression (Arikan et al, 2015). Greater recruitment of respiratory muscles may occur as the respiratory load increases, with recruitment of expiratory muscles during unsupported arm exercise (Cakmak et al, 2023).…”

“…In CF, muscle strength may also decrease with disease progression (Arikan et al., 2015). Greater recruitment of respiratory muscles may occur as the respiratory load increases, with recruitment of expiratory muscles during unsupported arm exercise (Cakmak et al., 2023). Muscle dysfunction has been suggested to be a contributor to the low exercise tolerance of children with CF (Moser et al., 2000), although this has not yet been studied in detail in adults with CF.…”

“…Several factors may be involved in the reduction of functional capacity in CF, such as ventilatory limitation, nutritional status, and electrolyte losses (Arikan et al., 2015; Pastré et al., 2014). In individuals with chronic airflow obstruction, exercise intolerance occurs not only when performing lower limb tasks but also during activities involving the arms (Cakmak et al., 2023). Thus, measures of functional capacity on exertion incorporating larger muscle groups are increasingly used in the follow‐up of CF adults to identify physical limitations, monitor the evolution of the disease and the effects of treatment, choose physical reconditioning programs, evaluate prognosis, and indicate lung transplantation (Burtin & Hebestreit, 2015; Moço et al., 2013).…”