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Title: Pulmonary rehabilitation in individuals with non-cystic fibrosis bronchiectasis: a systematic review
Austin Authors: Lee, Annemarie L;Hill, Catherine J ;McDonald, Christine F ;Holland, Anne E 
Affiliation: Institute for Breathing and Sleep
Respiratory and Sleep Medicine
West Park Healthcare Centre, Toronto, Ontario, Canada
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
Physiotherapy, Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Victoria, Australia
Issue Date: Apr-2017
Date: 2016-06-16
Publication information: Archives of Physical Medicine and Rehabilitation 2017; 98(4): 774-782
Abstract: OBJECTIVE: To examine the effect of pulmonary rehabilitation (PR) (exercise and education) or exercise training (ET) on exercise capacity, health-related quality of life (HRQOL), symptoms, frequency of exacerbations, and mortality compared with no treatment in adults with bronchiectasis. DATA SOURCES: Computer-based databases were searched from their inception to February 2016. STUDY SELECTION: Randomized controlled trials of PR or ET versus no treatment in adults with bronchiectasis were included. DATA EXTRACTION: Two reviewers independently extracted data and assessed methodologic quality using the Cochrane risk-of-bias tool. DATA SYNTHESIS: Four trials with 164 participants were included, with variable study quality. Supervised outpatient PR or ET of 8 weeks improved incremental shuttle walk distance (weighted mean difference [WMD]=67m; 95% confidence interval [CI], 52-82m) and disease-specific HRQOL (WMD=-4.65; 95% CI, -6.7 to -2.6 units) immediately after intervention, but these benefits were not sustained at 6 months. There was no effect on cough-related quality of life (WMD=1.3; 95% CI, -0.9 to 3.4 units) or psychological symptoms. PR commenced during an acute exacerbation and continued beyond discharge had no effect on exercise capacity or HRQOL. The frequency of exacerbations over 12 months was reduced with outpatient ET (median, 2 vs 1; P=.013), but PR initiated during an exacerbation had no impact on exacerbation frequency or mortality. CONCLUSIONS: Short-term improvements in exercise capacity and HRQOL were achieved with supervised PR and ET programs, but sustaining these benefits is challenging in people with bronchiectasis. The frequency of exacerbations over 12 months was reduced with ET only.
DOI: 10.1016/j.apmr.2016.05.017
Journal: Archives of Physical Medicine and Rehabilitation
PubMed URL:
Type: Journal Article
Subjects: Bronchiectasis
Patient education as topic
Disease progression
Exercise tolerance
Quality of life
Appears in Collections:Journal articles

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