Pulmonary Rehabilitation after exacerbation of bronchiectasis: a pilot randomized controlled trial

James D. Chalmers (Lead / Corresponding author), Megan L. Crichton, Gill Brady, Simon Finch, Mike Lonergan, Thomas Fardon

Research output: Contribution to journalArticle

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Abstract

Background: Pulmonary rehabilitation improves exercise capacity and reduces risk of future exacerbation in COPD when performed after an exacerbation. There have been no previous studies of post-exacerbation rehabilitation in bronchiectasis.

Methods: Parallel group randomized controlled trial compared pulmonary rehabilitation (PR) to standard care (SC) in patients followed an antibiotic treated exacerbation of bronchiectasis. Patients were randomized following a 14 day course of antibiotics was completed. The primary outcome was 6-min walk distance (6 MW) at 8 weeks. Secondary outcomes were time to the next exacerbation, St.Georges Respiratory Questionnaire, COPD CAT score, Leicester cough questionnaire (LCQ) and FEV1 at 8 and 12 weeks post exacerbation.

Results: Forty eight patients were enrolled but only 27 had exacerbations within 12 months of enrolment. Nine patients received pulmonary rehabilitation and 18 received standard care. The 6 MW improved significantly from post-exacerbation to 8 weeks in both groups, with no significant difference between PR and SC- mean difference of 11 m (95% CI -34.3 to 56.3,p = 0.6). Time to the next exacerbation was not significantly different hazard ratio 0.83 (0.31-2.19, p = 0.7). No significant differences were seen between groups in terms of LCQ, CAT, FEV1 or SGRQ between groups. An analysis of probability based on the patients enrolled suggested > 1000 subjects are likely be required to have an > 80% probability of observing a statistically significant difference between PR and SC and any such differences would be likely to be too small to be clinically relevant.

Conclusions: This pilot study identified no significant benefits associated with pulmonary rehabilitation after exacerbations of bronchiectasis.

Trial registration: NCT02179983, registered on Clinicaltrials.gov 29th June 2014.

Original languageEnglish
Article number85
Pages (from-to)1-9
Number of pages9
JournalBMC Pulmonary Medicine
Volume19
DOIs
Publication statusPublished - 6 May 2019

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