Impaired arm exercise capacity and increased energy expenditure during activities of daily living in patients with bronchiectasis compared to controls

Abstract

Background: Upper extremity exercise has been identified as a part of pulmonary rehabilitation. Determination of arm exercise capacity may be predictive for maintaining and improving upper extremity and activities of daily living (ADL) in patients with chronic lung disease. Aim: We aimed to determine arm exercise capacity and ADL performance in patients with bronchiectasis and compare with healthy controls. Methods: We included 12 bronchiectasis patients (8F, 4M, 35.2±17.2 years, FEV1 73.12±12.1% pred) and ten controls (8F, 2M, 39.0±7.9 years, FEV1 93.3±14.2% pred.). The arm exercise capacity and ADL performance were assessed using 6-minute pegboard and ring test (6PBRT) and Glittre ADL test, respectively. Energy expenditure during Glittre ADL test was measured using a multi-sensor armband. Results: The 6PBRT score was significantly lower in patients with bronchiectasis as compared to controls (p=0.018). Energy expenditure during Glittre ADL test was significantly higher in patients with bronchiectasis (p=0.021) even though there was no significant difference in ADL test duration between the groups (p>0.05). Conclusions: Patients with bronchiectasis have reduced arm exercise capacity compared with controls. Since oxygen cost of breathing constitutes an important part of energy expenditure during exercise, increased cost of oxygen may be explanatory for increased energy expenditure during activities in patients despite similar test duration to healthy controls. This may be led by an increased oxygen use of respiratory muscles in a particular workload and the loss of lean body mass in patients with bronchiectasis.