Home-based pulmonary rehabilitation in patients with bronchiectasis: a randomized controlled trial

Background: A home-based pulmonary rehabilitation (HBPR) is a promising alternative to help patients overcome the barriers that cause lack of adherence in pulmonary rehabilitation (PR). However, HBPR has not yet been investigated in patients with bronchiectasis. Objective: To investigate the impact of HBPR on functional capacity, quality of life, and peripheral muscle strength in patients with bronchiectasis. Methods: 39 patients were randomized into two groups: HBPR (n=20, 44±18 years, FEV 1 : 51±22%): three sessions weekly for eight weeks with aerobic exercise (stepping training during 20 minutes) and resistance training using elastic bands. Controls (n=19, 47±14 years, FEV 1 : 45±16%): Educational manual and a recommendation for a practice of exercises. All patients received a weekly phone call and the HBPR group received a home visit every 15 days. The incremental shuttle walk test (ISWT), endurance shuttle walk test (ESWT), quality of life (Saint George`s Respiratory Questionnaire, SGRQ) and quadriceps muscle strength were taken at baseline and after the intervention. * = P Results: The HBPR group and controls presented, respectively: difference in ISWT: 89±77m* and -70±122m* [(difference between groups: 160m* (95%CI: 93 to 227m)], ESWT: 5.6±5.7 min* and 0.2±2.2 min [5.4 min* (95%CI: 2.1 to 8.7)], SGRQ: -9±12%* and 4±9% [-12%* (95%CI: -19 to -5)], quadriceps strength: 6.4±8.4 kgf* and -1.0±6.1 kgf [7.4 kgf* (95%CI: 2.6 to 12.3)]. Conclusion: The HBPR improved functional capacity, quality of life and muscle strength in patients with bronchiectasis. The HBPR is safe and can be an alternative for patients who cannot participate in an outpatient PR program.