Reduced Physical Activity With Bronchiectasis

Abstract

BACKGROUND: Bronchiectasis leads to reduced functional capacity, which might have implications for physical activity. The impact of dyspnea and long-term oxygen therapy on physical activity has never been investigated in subjects with bronchiectasis. Based on these findings, specific strategies could be applied to allow individuals to be more active in their daily life. In this study we aimed to evaluate physical activity, the impact of dyspnea and long-term oxygen therapy on physical activity, and the determinants of physical activity in subjects with bronchiectasis. METHODS: We performed a cross-sectional study in 139 subjects with bronchiectasis (age 45 ؎ 13 y, FVC 70 ؎ 22% of predicted, FEV 1 54 ؎ 25% of predicted) and 49 healthy subjects as controls. Physical activity was assessed using steps per day (measured with a pedometer), spirometry, incremental shuttle walking test (ISWT), and dyspnea. RESULTS: Reduced physical activity was observed in subjects with bronchiectasis, who recorded a median (interquartile range) of 8,007 (5,131-10,432) steps/d compared with controls, who recorded 10,994 (8,551-14,078) steps/d (P < .001). Significant correlations were observed between physical activity and FVC (r ‫؍‬ 0.43), FEV 1 (r ‫؍‬ 0.36), ISWT (r ‫؍‬ 0.37), and dyspnea (r ‫؍‬ ؊0.48). Determinants for reduced physical activity included pulmonary function (R 2 ‫؍‬ 0.150), dyspnea (R 2 ‫؍‬ 0.075), ISWT (R 2 ‫؍‬ 0.044), and long-term oxygen therapy (R 2 ‫؍‬ 0.038); these factors explained 32% of the physical activity. CONCLUSION: Subjects with bronchiectasis exhibited reduced physical activity compared with healthy peers. Dyspnea has a negative impact on physical activity. Independent factors associated with physical activity included pulmonary function, dyspnea, functional capacity, and long-term oxygen therapy. These findings will guide strategies to enhance daily physical activity and to encourage subjects with bronchiectasis to be more active.

Home-based pulmonary rehabilitation in people with bronchiectasis: a randomised controlled trial

“…7,23 Our group has previously demonstrated that people with bronchiectasis present an important reduction in daily physical activity. 3 The HBPR proposed in this study demonstrate an increase in daily steps above the minimum important difference values for people with COPD (600 steps). 30 The improvement in physical activity after HBPR in people with bronchiectasis has been previously demonstrated using a questionnaire, 10 something that was confirmed in our study through direct measurement using accelerometers.…”

“…Our group has demonstrated previously that people with bronchiectasis present an important reduction in daily physical activity [ 3 ]. The HBPR proposed in this study demonstrate an increase in daily steps above the minimum important difference values for people with COPD (600 steps) [ 30 ].…”

“…1 In addition to respiratory symptoms, bronchiectasis leads to extrapulmonary manifestations such as fatigue, reduced exercise capacity, peripheral muscle endurance, daily physical activity and health status. [2][3][4] Pulmonary rehabilitation has been considered part of the comprehensive approach to bronchiectasis management, 5 but is still underused in this population. A recent systematic review found only four randomized clinical trials on pulmonary rehabilitation for patients with bronchiectasis.…”

The disease burden of bronchiectasis in comparison with chronic obstructive pulmonary disease: a national database study in Korea

“…Subjects with bronchiectasis often suffer from respiratory symptoms (1), decreased physical activity (9,10), impaired quality of life (11)(12)(13), and comorbidities (14). In addition, bronchiectasis is associated with markedly increased healthcare costs and mortality (5,14).…”

Desaturation during exercise is not a sufficient mechanism for prediction of osteoporosis in non-cystic fibrosis bronchiectasis

“…In addition to the above mechanistic factors, recent research that has shown PA is low in patients with noncystic fibrosis bronchiectasis relative to non-diseased controls; and positively associated with measures of lung function and exercise performance [15]. Given these factors, we believe that it is more likely that reduced PA is responsible for low BMD in this population, and not the HIF-1α pathway, although we admittedly do not have evidence to completely refute the HIF-1α pathway.…”