Effects Of A Therapeutic Exercise Program In Children With Non-cf Bronchiectasis

Abstract

Non-cystic fibrosis (non-CF) bronchiectasis is a major contributor to respiratory morbidity in children and youth. Current guidelines for this patient group recommend regular exercise to improve clinical outcomes including cardiovascular fitness and quality of life. However, no study has yet evaluated the effects of exercise therapy in children with non-CF bronchiectasis. PURPOSE: To evaluate the effect of a 7-week movement program on fundamental movement skill (FMS) proficiency, cardiorespiratory fitness, perceived movement competence, and health-related quality of life (HR-QoL) in children with non-CF bronchiectasis. METHODS: Children (n = 21) investigated, mean age 7.1 ± SD 2.3 years with non-CF bronchiectasis were randomly allocated to an exercise or control group. The program consisted of 7 weekly sessions plus home exercises. Each 60-minute session consisted of 6 different developmentally appropriate games, each targeting a specific FMS. The TGMD 2 was used to assess FMS; cardiovascular fitness was assessed measuring % change in exercising heart rate (HR); perceived competence was evaluated by the athletic competence subscale from Harter’s Self-Perception Profile for children. HR-QoL was assessed with the PedsQL and parental cough-specific quality of life (PCQOL). A two-way ANOVA was used to assess the effects of the program. Data were analysed according to the intention to treat principle. RESULTS: Average HR during sessions was 137 ± 12 bpm. There was a significant group x time interaction for both FMS subgroups, locomotor (F(1,19) = 7.6, p = 0.01) and object control skills (F(1,19) = 8.3, p = 0.01). The exercise group exhibited improvements in both locomotor (pre 29 ± 2.0, post 35.2 ± 2.2) and object control (pre 27.0 ± 2.0, post 35.5 ± 2.2), while the control group showed minimal changes. The associated effect sizes (Cohen’s d = 1.2 and 1.3, respectively) indicated a large effect on FMS. The program improved cardiovascular fitness (5.9% decline in Delta HR) with an effect size commensurate with that reported for asthmatic children completing exercise training (d = 0.5). There were no significant changes in perceived competence and HR-QoL. CONCLUSION: A 7-week movement program increases FMS proficiency in children with non-CF bronchiectasis and has a moderate positive effect on cardiovascular fitness.