A Comparison of Combined Pulmonary Rehabilitation and Chest Physiotherapy versus Chest Physiotherapy alone in Bronchiectasis
Keywords:
Bronchiectasis, Pulmonary Rehabilitation, Chest Physiotherapy, Exercise Capacity, Quality of LifeAbstract
Background: Bronchiectasis is a chronic respiratory illness defined by irreversible dilation of airways, mucus trapping, and recurrent infections, and decreased quality of life. Although chest physiotherapy (CPT) assists in airway clearance, the synergistic effect of pulmonary rehabilitation (PR) combined with CPT on functional, clinical, and quality of life measures is not entirely established. Objective: To compare the effectiveness of pulmonary rehabilitation in combination with chest physiotherapy to chest physiotherapy alone in patients with bronchiectasis. Methodology: A total of 140 stable bronchiectasis patients were randomly allocated to a PR + CPT or a CPT-only group in this randomized controlled trial. The intervention was for a duration of eight weeks, during which PR involved supervised aerobic and resistance training, breathing retraining, and patient education. Outcomes measured were exercise tolerance (6-minute walk test), lung function (FEV1, FVC), dyspnea (mMRC and Borg scores), health-related quality of life (St. George's Respiratory Questionnaire), daily sputum volume, exacerbations, and healthcare utilization. Results: The two groups were similar at baseline. At eight weeks, the PR + CPT group had significantly larger improvements in exercise tolerance (+60.3 m vs. +21.1 m, p < 0.001), lung function (FEV1 +5.5% vs. +1.9%, p = 0.01; FVC +3.3% vs. +1.6%, p = 0.02), dyspnea scores, quality of life (SGRQ total score ?12.7 vs. ?5.6, p = 0.004), and morning sputum volume (?17.1 mL vs. ?7.5 mL, p = 0.002) compared with CPT alone. Conclusion: Pulmonary rehabilitation with chest physiotherapy yields greater advantages than chest physiotherapy alone in bronchiectasis. The combined intervention improves exercise capacity, lung function, symptom control, quality of life, and reduces exacerbations and health care use, warranting its addition to regular bronchiectasis care.References
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