|Type||Journal Article (Review)|
|Journal||Archives of physical medicine and rehabilitation|
|Year of Publication||2016|
|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 to 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 methodological 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 eight weeks improved incremental shuttle walk distance (weighted mean difference (WMD): 67m; 95% CI 52 to 82m) and disease-specific HRQOL (WMD -4.65, 95% CI -6.7 to -2.6 units) immediately following intervention, but these benefits were not sustained at six months. There was no effect on cough-related QOL (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 reduced with outpatient ET (median 2 versus 1, p=0.013), but PR initiated during an exacerbation had no impact on exacerbation frequency or mortality. CONCLUSION: 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|
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