Article

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
with 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 methodologic 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 8 weeks improved
incremental shuttle walk distance (weighted mean difference [WMD]=67m; 95%
confidence interval [CI], 52-82m) and disease-specific HRQOL (WMD=-4.65; 95% CI,
-6.7 to -2.6 units) immediately after intervention, but these benefits were not
sustained at 6 months. There was no effect on cough-related quality of life
(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 was
reduced with outpatient ET (median, 2 vs 1; P=.013), but PR initiated during an
exacerbation had no impact on exacerbation frequency or mortality. CONCLUSIONS:
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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS