title: The short and long term effects of exercise training in non-cystic fibrosis bronchiectasis--a randomised controlled trial.
abstract: BACKGROUND
  Exercise training is recommended for non-cystic fibrosis (CF) bronchiectasis, but the long-term effects are unclear. This randomised controlled trial aimed to determine the effects of exercise training and review of airway clearance therapy (ACT) on exercise capacity, health related quality of life (HRQOL) and the incidence of acute exacerbations in people with non-CF bronchiectasis.
  
  
  METHODS
  Participants were randomly allocated to 8 weeks of supervised exercise training and review of ACT, or control. Primary outcomes of exercise capacity and HRQOL (Chronic respiratory disease questionnaire) and secondary outcomes of cough-related QOL (Leicester cough questionnaire) and psychological symptoms (Hospital anxiety and depression scale) were measured at baseline, following completion of the intervention period and at 6 and 12 months follow up. Secondary outcomes of the exacerbation rate and time to first exacerbation were analysed over 12 months.
  
  
  RESULTS
  Eighty-five participants (mean FEV1 74% predicted; median Modified Medical Research Council Dyspnoea grade of 1 (IQR [1-3]) were included. Exercise training increased the incremental shuttle walk distance (mean difference to control 62 m, 95% CI 24 to 101 m) and the 6-minute walking distance (mean difference to control 41 m, 95% CI 19 to 63 m), but these improvements were not sustained at 6 or 12 months. Exercise training reduced dyspnoea (p = 0.009) and fatigue (p = 0.01) but did not impact on cough-related QOL or mood. Exercise training reduced the frequency of acute exacerbations (median 1[IQR 1-3]) compared to the control group (2[1-3]) over 12 months follow up (p = 0.012), with a longer time to first exacerbation with exercise training of 8 months (95% CI 7 to 9 months) compared to the control group (6 months [95% CI 5 to 7 months], p = 0.047).
  
  
  CONCLUSIONS
  Exercise training in bronchiectasis is associated with short term improvement in exercise capacity, dyspnoea and fatigue and fewer exacerbations over 12 months.
  
  
  BACKGROUND
  ClinicalTrials.gov (NCT00885521).
authors.affiliation: Alfred Health, Commercial Road, Melbourne 3004, Victoria, Australia. Annemarie.Lee@alfred.org.au.
authors.forename: Annemarie L
authors.initials: AL
authors.lastname: Lee
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Hill
authors.forename: Nola
authors.initials: N
authors.lastname: Cecins
authors.forename: Sue
authors.initials: S
authors.lastname: Jenkins
authors.forename: Christine F
authors.initials: CF
authors.lastname: McDonald
authors.forename: Angela T
authors.initials: AT
authors.lastname: Burge
authors.forename: Linda
authors.initials: L
authors.lastname: Rautela
authors.forename: Robert G
authors.initials: RG
authors.lastname: Stirling
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Thompson
authors.forename: Anne E
authors.initials: AE
authors.lastname: Holland
mesh_terms: D000368:Aged; D001987:Bronchiectasis / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D003550:Cystic Fibrosis; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005081:Exercise Therapy / Q000379:methods / Q000523:psychology / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
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