Benefits of exercise training in bronchiectasis: a randomized controlled trial design

Abstract

Background: Bronchiectasis is a chronic, progressive and persistent inflammatory lung disease which causes exercise intolerance and physical activity limitations, among others. Bronchiectasis patients experience worse dyspnoea perception and increased fatigue during exercise. Daily physical limitations are related to impaired health-related quality of life. Current treatment involves therapy for exacerbations and/or direct physiopathological factors of the disease but no treatment is targeting to improve peripheral symptoms. Some literature assessing effects of exercise training programmes in bronchiectasis reported beneficious outcomes regarding exercise capacity, although conclusions provided were low-quality evidence based. Hypothesis and Objectives: We hypothesize that exercise training is effective in improving exercise tolerance. Therefore, the aim of this study is to evaluate the effect of an exercise training rehabilitation programme using an objective method to estimate the cardiorespiratory function in order to supply with rigorous data. Secondary objectives are to assess impact of exercise training in other relevant clinical variables such as respiratory muscle strength, number of exacerbations, dyspnoea perception, quality of life and pulmonary capacity. Methods and Materials: This is a single institution, prospective, parallel controlled clinical trial. The study includes 114 patients with stable bronchiectasis and exercise intolerance from Hospital Josep Trueta’s bronchiectasis-specialized unit. Patients will be randomly distributed into two groups: a control group (CG), which will receive usual care (ELTGOL technique), and the intervention group (IG), which will receive an 8-week exercise training rehabilitation programme and concomitant usual care (ELTGOL technique). Training sessions will be performed 3 times per week and will consist in interval endurance training, peripheral muscle strength training and respiratory muscle training. Data will be collected at the study onset and immediately after the end of the 8-week training sessions. Variables analysed will be maximum oxygen consumption, dyspnoea perception, quality of life, maximal respiratory pressures and pulmonary capacity. After intervention, there will be a 1-year period of follow-up to determine incidence of exacerbations of both groups.