Short-and Long-term Effects of a Home-based Rehabilitation Program in Patients With Bronchiectasis

Study Overview
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Brief Summary
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This study will investigate the short-and long-term effects of the home-based pulmonary rehabilitation on peripheral muscle strength, functional capacity and quality of life in patients with bronchiectasis. The participants will be randomized into two groups: control group (usual care and recommendations for practice exercise) and training group, that will perform aerobic (stepping training) and resistance training (lower and upper limbs) for eight weeks, three times a week. At baseline, immediately after finishing and after six months the patients will undergo assessments.

Detailed Description
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Home-based pulmonary rehabilitation (HBPR) has been used in patients with chronic obstructive pulmonary disease, asthma and pulmonary fibrosis. Results from HBPR have been similar to those observe in the outpatient pulmonary rehabilitation such improvement in exercise capacity, symptoms and quality of life. However, HBPR has not yet been investigated in patients with bronchiectasis, a progressive and debilitating disease with a high socioeconomic impact. Objective: To investigate the short-and long-term effects of the home rehabilitation program in peripheral muscle strength, functional capacity and quality of life in patients with bronchiectasis. Methods: Patients diagnosed with bronchiectasis will be recruited from the Obstructive Diseases Outpatient Clinic of the Hospital das Clínicas - Medicine School, University of São Paulo. Participants will be randomized into two groups: control group (usual care and recommendations for performing exercises and respiratory physiotherapy) and training group, that will perform aerobic (stepping training) and resistance training (lower and upper limbs) for eight weeks, three times a week. All patients will receive a phone call once a week and patients allocated to the training group, additionally, will get a home visit every 15 days. At baseline, immediately after finishing and after six months of the HBPR patients will undergo to assessments. Expected results: HBPR will have positive effects on exercise tolerance and quality of life. Also, this study will contribute to future guidelines on the recommendation of HBPR for patients with bronchiectasis.

Official Title
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Short-and Long-term Effects of a Home-based Rehabilitation Program on Functional Capacity, Peripheral Muscle Strength and Quality of Life in Patients With Bronchiectasis: Randomized Controlled Trial

Conditions
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Bronchiectasis

Intervention / Treatment
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* Other: Training Group
* Other: Control Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Clinical diagnosis and/or tomographic bronchiectasis Clinically stable (no change in symptoms of dyspnea, in the amount and color of the secretion) Have completed the outpatient pulmonary rehabilitation for more than a year Not engaged in a regular physical activity. Exclusion Criteria: Smokers With other lung related diseases (asthma, COPD and cystic fibrosis) Severe cardiovascular diseases Musculoskeletal limitation Unable to perform the tests and the training protocol due desaturation (pulse oxygen saturation ≤ 80%) over the recommended exercise intensity.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Training Group<br>Patients with bronchiectasis in home-based pulmonary rehabilitation | Other: Training Group<br>* Three sessions per week, each lasting 50 minutes, during eight weeks. Aerobic training in stepping training. Resistance training: Three sets of eight repetitions each, in both simultaneous members, using an elastic band. The trained muscles are quadriceps, hamstrings, deltoid and biceps. Once a week, patients will receive a phone call and every two weeks, patients will get a visit of the researcher at his home.<br>* Other names: Physical training intervention;|
| Active Comparator: Control Group<br>Patients with bronchiectasis in usual care and recommendations for performing exercises | Other: Control Group<br>* The participants will receive verbal and written information about the importance of physical activity and walk in moderate intensity, at least, three times a week for 30 minutes. Participants will not receive any supervised physical training. Once a week, patients will receive a phone call to provide support and general advice.<br>* Other names: Physical activity intervention;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Distance, in meters, performed in the Incremental Shuttle Walk Test | Measurement of functional capacity and exercise tolerance | up to 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time, in seconds, performed in the Endurance Shuttle Walk Test | Measurement of functional capacity and exercise tolerance | up to 9 monthsst | 
| Number of steps performed in the Incremental Step Test | Measurement of functional capacity and exercise tolerance | up to 9 months | 
| Physical functioning domain scale in the Quality of Life Questionnaire-Bronchiectasis (QoL-B) | Quality of Life Questionnaire | up to 9 months | 
| Kilogram-force (kgf) of quadriceps femoris | Peripheral Muscle Strength | up to 9 months | 
| Number of steps per day, measured by a pedometer | Physical activity in daily life | up to 9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bronchiectasis, Rehabilitation, Quality of Life, Physiotherapy Specialty