The short and long term effects of exercise training in non-cystic fibrosis bronchiectasis - a randomised controlled trial

被引:105
|
作者
Lee, Annemarie L. [1 ,2 ,3 ]
Hill, Catherine J. [2 ,4 ]
Cecins, Nola [5 ,6 ,7 ]
Jenkins, Sue [5 ,6 ,7 ,8 ]
McDonald, Christine F. [2 ,4 ]
Burge, Angela T. [1 ]
Rautela, Linda [2 ,4 ]
Stirling, Robert G. [1 ,9 ]
Thompson, Philip J. [5 ,6 ,7 ,8 ]
Holland, Anne E. [1 ,2 ,10 ]
机构
[1] Alfred Hlth, Melbourne, Vic 3004, Australia
[2] Inst Breathing & Sleep, Heidelberg, Vic 3084, Australia
[3] Univ Melbourne, Melbourne Sch Hlth Sci, Carlton, Vic 3010, Australia
[4] Austin Hlth, Heidelberg, Vic 3084, Australia
[5] Sir Charles Gairdner Hosp, Perth, WA 6009, Australia
[6] Lung Inst Western Australia, Perth, WA 6009, Australia
[7] Ctr Asthma, Perth, WA 6009, Australia
[8] Curtin Univ, Perth, WA 6102, Australia
[9] Monash Univ, Dept Med, Melbourne, Vic 3800, Australia
[10] La Trobe Univ, Melbourne, Vic 3086, Australia
关键词
Bronchiectasis; Exercise training; Quality of life; Exercise capacity; Acute exacerbations; RESPIRATORY SOCIETY STATEMENT; LUNG-FUNCTION DECLINE; PULMONARY REHABILITATION; UNITED-STATES; QUESTIONNAIRE; MORTALITY; CAPACITY; BURDEN; TRENDS;
D O I
10.1186/1465-9921-15-44
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Background: Exercise training is recommended for non-cystic fibrosis (CF) bronchiectasis, but the long-term effects are unclear. This randomised controlled trial aimed to determine the effects of exercise training and review of airway clearance therapy (ACT) on exercise capacity, health related quality of life (HRQOL) and the incidence of acute exacerbations in people with non-CF bronchiectasis. Methods: Participants were randomly allocated to 8 weeks of supervised exercise training and review of ACT, or control. Primary outcomes of exercise capacity and HRQOL (Chronic respiratory disease questionnaire) and secondary outcomes of cough-related QOL (Leicester cough questionnaire) and psychological symptoms (Hospital anxiety and depression scale) were measured at baseline, following completion of the intervention period and at 6 and 12 months follow up. Secondary outcomes of the exacerbation rate and time to first exacerbation were analysed over 12 months. Results: Eighty-five participants (mean FEV1 74% predicted; median Modified Medical Research Council Dyspnoea grade of 1 (IQR [ 1-3]) were included. Exercise training increased the incremental shuttle walk distance (mean difference to control 62 m, 95% CI 24 to 101 m) and the 6-minute walking distance (mean difference to control 41 m, 95% CI 19 to 63 m), but these improvements were not sustained at 6 or 12 months. Exercise training reduced dyspnoea (p = 0.009) and fatigue (p = 0.01) but did not impact on cough-related QOL or mood. Exercise training reduced the frequency of acute exacerbations (median 1[ IQR 1-3]) compared to the control group (2[ 1-3]) over 12 months follow up (p = 0.012), with a longer time to first exacerbation with exercise training of 8 months (95% CI 7 to 9 months) compared to the control group (6 months [ 95% CI 5 to 7 months], p = 0.047). Conclusions: Exercise training in bronchiectasis is associated with short term improvement in exercise capacity, dyspnoea and fatigue and fewer exacerbations over 12 months.
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页数:10
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