Pulmonary Rehabilitation in Noncystic Fibrosis Bronchiectasis.

ABSTRACT

BACKGROUND: Current guidelines for the treatment of noncystic fibrosis bronchiectasis (NCFB) recommend pulmonary rehabilitation (PR), but to date, there are few studies that have proven its effectiveness. OBJECTIVE: The main objective of this study was to examine the effect of PR on pulmonary function tests and exercise capacity. METHOD: The aim of this study was to systematically review the effects of PR in NCFB on (1) forced expiratory volume in the first second (FEV1) and (2) exercise capacity evaluated by the 6-min walk test (6MWT) and the incremental shuttle walk test (ISWT). This meta-analysis was undertaken according to PRISMA recommendations. RESULTS: This pair-wise meta-analysis included data obtained from studies that enrolled 529 NCFB patients. The FEV1 assessment after PR between the active and control group did not show any significant increase (FEV1 difference 0.084 mL; CI -0.064, +0.233; p = 0.264), and there was an increasing trend (188 mL; CI -0 to 0.009, +0.384) at the limits of statistical significance (p = 0.061). Walked distance showed a significant increase in the PR group compared to the control group (ISWT distance difference 070.0 m; CI 55.2, 84.8; p < 0.001), and this finding was confirmed before and after PR both by the ISWT (68.85 m greater than baseline; CI 40.52, 97.18; p < 0.001) and by the 6MWT (37.7 m greater than baseline; CI 20.22, 55.25; p < 0.001). CONCLUSIONS: PR improves exercise tolerance in NCFB patients, but it has a modest impact on respiratory function.