Pulmonary Rehabilitation in Noncystic Fibrosis Bronchiectasis

Abstract

<b><i>Background:</i></b> Current guidelines for the treatment of noncystic fibrosis bronchiectasis (NCFB) recommend pulmonary rehabilitation (PR), but to date, there are few studies that have proven its effectiveness. <b><i>Objective:</i></b> The main objective of this study was to examine the effect of PR on pulmonary function tests and exercise capacity. <b><i>Method:</i></b> The aim of this study was to systematically review the effects of PR in NCFB on (1) forced expiratory volume in the first second (FEV<sub>1</sub>) and (2) exercise capacity evaluated by the 6-min walk test (6MWT) and the incremental shuttle walk test (ISWT). This meta-analysis was undertaken according to PRISMA recommendations. <b><i>Results:</i></b> This pair-wise meta-analysis included data obtained from studies that enrolled 529 NCFB patients. The FEV<sub>1</sub> assessment after PR between the active and control group did not show any significant increase (FEV<sub>1</sub> difference 0.084 mL; CI: −0.064, +0.233; <i>p</i> = 0.264), and there was an increasing trend (188 mL; CI: −0 to 0.009, +0.384) at the limits of statistical significance (<i>p</i> = 0.061). Walked distance showed a significant increase in the PR group compared to the control group (ISWT distance difference 070.0 m; CI: 55.2, 84.8; <i>p</i> < 0.001), and this finding was confirmed before and after PR both by the ISWT (68.85 m greater than baseline; CI: 40.52, 97.18; <i>p</i> < 0.001) and by the 6MWT (37.7 m greater than baseline; CI: 20.22, 55.25; <i>p</i> < 0.001). <b><i>Conclusions:</i></b> PR improves exercise tolerance in NCFB patients, but it has a modest impact on respiratory function.

Exacerbation Prevention and Management of Bronchiectasis

“…Recently, two meta-analyses were published that aimed to evaluate the efficacy of PR in bronchiectasis patients. Ora et al [ 29 ] analyzed the effectiveness of PR on pulmonary function and exercise tolerance in non-cystic bronchiectasis patients. There was no significant improvement in forced expiratory volume in 1 second (FEV 1 ) in the PR group, compared to control group.…”