Pulmonary Rehabilitation For People Research Articles

High-flow nasal cannula during pulmonary rehabilitation for people with chronic obstructive pulmonary disease: Asystematic review and meta-analysis.

Chronic obstructive pulmonary disease (COPD) is an increasingly concerning global public health issue due to its high burden of morbidity and mortality. Pulmonary rehabilitation (PR) is a comprehensive intervention to improve patients' physical and psychological conditions, commonly involving oxygen supplementation. The potential benefits of high-flow nasal cannula (HFNC) have recently sparked interest as oxygen therapy. In this context, this study aims to assess the effects of HFNC during the exercise training component of a PR program in people with COPD. Systematic review (CRD42022330929). We included randomised controlled trials (RCTs), including crossover RCTs with adults with stable COPD. We included trials using oxygen therapy with HFNC during the exercise training component of a PR programme. disease-specific health-related quality of life (HRQoL), exercise capacity (EC) and adverse events. treatment adherence, breathlessness and future exacerbations. We included five studies with 300 participants with moderate to severe COPD. The certainty of the evidence was primarily low or very low for all outcomes of interest due to risk of bias, inconsistency or imprecision. HFNC has little to no difference in HRQoL (4 studies, 129 participants, MD 0.17, 95% CI -1.20 to 1.54; I2 50%). HFNC may result in little to no difference in EC (3 studies, 212 participants, mean difference 18.73, 95% CI -20.49 to 28.94; I2 56%), and we are uncertain about the effect of HFNC on breathlessness (4 studies; 244 participants, MD of -0.07, 95% CI -0.4 to 0.26; I2 63%). Only one study with 44 participants reported a participant's withdrawal because of progressive dyspnoea during lower limb exercise. We are uncertain about the effect of HFNC during the exercise component of a PR programme in HRQoL, EC or dyspnoea compared to usual care or conventional supplementary oxygen. Non-domiciliary oxygen patients showed improvements in HRQoL, EC and dyspnoea.

Perceptions and Beliefs Associated with Enrolling in Pulmonary Rehabilitation in People with Chronic Respiratory Diseases: A Qualitative Study

Purpose: To explore the reasons people with chronic respiratory diseases (CRD) accept enrollment in pulmonary rehabilitation (PR) using a framework of health behaviour change, to ascertain which motivational processes resulted in the intention to enroll in PR. Methods: Semi-structured interviews informed by the Health Action Process Approach (HAPA) framework were conducted with individuals with CRD who were referred to for PR. Content analysis was performed. Results: Eleven participants [accept PR ( n = 10), decline PR ( n = 1); COPD ( n = 5), interstitial lung disease ( n = 6); female ( n = 5), median age = 72 (range 35–84 years)] completed the interviews. Four themes were identified: (1) communication, (2) extrinsic factors, (3) psychosocial factors, and (4) past experiences. Conclusions: Participants perceived enrollment in PR to be impacted by the information acquired from sources in addition to their healthcare providers, logistics associated with accessing PR, perception of their current capabilities, the belief that PR was their last resource for improvement and past experiences regarding knowledge about exercise and symptoms. To increase enrollment in PR programs, healthcare providers should prioritize effective communication, address concerns and misconceptions, consider accessibility, and understand/address psychosocial factors such as motivation and belief systems.

One-year sustained and clinically meaningful outcomes following pulmonary rehabilitation in people with difficult-to-treat or severe asthma

One-year sustained and clinically meaningful outcomes following pulmonary rehabilitation in people with difficult-to-treat or severe asthma

Functional status following pulmonary rehabilitation in people with ECOPD: A systematic review and meta-analysis

Functional status following pulmonary rehabilitation in people with ECOPD: A systematic review and meta-analysis

Baseline dependent minimally important differences for clinical outcomes of pulmonary rehabilitation in people with COPD

IntroductionMinimally important differences (MIDs) for common outcomes of pulmonary rehabilitation are well documented for people with chronic obstructive pulmonary disease (COPD). It is not known whether MIDs differ based on COPD disease characteristics. This study aimed to estimate MIDs for clinical outcomes of pulmonary rehabilitation dependent upon baseline characteristics. MethodsA database containing 2791 people with COPD was split into derivation (n=2245; age 66±9 years; 50% males; FEV1 47±20% predicted) and comparator (n=546; age 66±9 years; 47% males; FEV1 46±21% predicted) cohorts. MIDs were estimated using 0.5 x SD (symmetrically distributed) or 0.5 x IQR (non-symmetrically distributed) for: 6-minute walk test (6MWT), constant work rate test (CWRT), COPD assessment test (CAT), St. George's respiratory questionnaire (SGRQ), hospital anxiety and depression scale (HADS), and fat-free mass index (FFMI). MIDs were estimated based on baseline outcome scores, lung function, modified medical research council (mMRC) grade and FFMI. ResultsMID estimates were comparable to previously reported values. MIDs for SGRQ domains (Symptom=8.7 points, Activity=7.1 points, Impact=8.1 points) and FFMI were produced (0.36kg/m2). There was greater variation of change in 6MWT, SGRQ-activity, SGRQ-impact, HADS and FFMI on which the MIDs were determined when categorising for baseline values (all, p<0.05). Greater variation of change in 6MWT on which the MIDs were determined was evident with COPD disease severity grouping (p<0.05). The magnitude of change in 6MWT, CAT, CWRT, SGRQ-activity, and FFMI with baseline mMRC score categorisation resulted in greater variation on which the MIDs were determined (all, p<0.05). Baseline stratification for FFMI resulted in greater variation of change in CWRT (p<0.001) and HADS-depression (p = 0.043) on which MIDs were determined. DiscussionFindings suggest that baseline presentation should be considered for people with COPD when assessing the efficacy of pulmonary rehabilitation. However, clinical significance of the variation underpinning MIDs is yet to be determined.

Year in Review: Long COVID and Pulmonary Rehabilitation

There have been an estimated 100 million people diagnosed with COVID-19 in the United States, with a majority of patients reporting persistent symptoms expressed as long COVID. The 2 most frequently reported long COVID symptoms are shortness of breath and fatigue. Exercise training during pulmonary rehabilitation (PR) is a successful strategy for improving the lives of people with persistent respiratory symptoms caused by a variety of lung diseases. This narrative review assessed the impact of exercise interventions on functional exercise capacity measures and related symptoms (dyspnea, fatigue) in people with long COVID over the last year. Articles were accessed through electronic databases including PubMed, Embase, CINAHL Plus with full text (EBSCO), and LitCovid. Findings for this Year in Review revealed that exercise interventions and PR show promise for improving functional exercise capacity, dyspnea, and fatigue in people with long COVID. This review supports the need for more rigorous scientific studies on the benefits of structured PR in people with long COVID who have respiratory-related symptoms.

FEV1 and pulmonary rehabilitation: Let's get the facts straight.

Pulmonary rehabilitation (PR) is a miracle intervention. Despite the lack of effect on resting lung function,1 symptomatic people with chronic obstructive pulmonary disease (COPD) generally have less symptoms (i.e., dyspnea, fatigue, anxiety and depression), better physical functioning and physiological exercise responses, less care dependency, an improved performance of activities of daily life, less healthcare use and an improved quality of life following a 8–12 weeks multidisciplinary PR program on top of the regular respiratory drug treatment.2-10 To date, post-bronchodilator forced expiratory volume in the first second (FEV1) is still often used as a selection criterion for referral for PR.11, 12 However, FEV1 is useless for this objective. Let us get the facts straight: Fact 1: Baseline FEV1 does not or only weakly correlate with physical, emotional and social functioning of people with COPD. Daily symptoms (such as dyspnea, fatigue, anxiety and depression), abnormal body composition, low exercise capacity, problematic activities of daily life, low physical activity and an impaired health status can occur in people with COPD, irrespective of the degree of airflow limitation.13-18 Moreover, FEV1 is only weakly correlated with the number of extra-pulmonary traits.18 So, FEV1 cannot be used to identify symptomatic people with limitations in daily functioning and extra-pulmonary traits, which can be addressed during a comprehensive PR program.2 Fact 2: Baseline FEV1 does not predict the likelihood of dropping out. PR programs report that 15%–40% of the participants drop out from the program.5, 19-25 Generally, people with COPD who drop out have similar baseline FEV1 compared to those who complete the PR program.19-22, 24 The presence of psychological factors (i.e., depressive symptoms, lack of motivation and/or distress arising from bodily perceptions), social factors (i.e., transportation difficulties, other duties or responsibilities, unsupportive remarks by staff or patients and/or conflict with other patients) and/or people's perception of insufficient improvements during the PR program, may partially explain why people with COPD drop out, irrespective of baseline FEV1.24, 26 So, baseline FEV1 cannot be used to identify people at risk of dropping out from a PR program. Fact 3: PR improves exercise capacity, symptoms and health status across all grades of COPD severity. Improvements in the abovementioned outcomes have been reported in people with a variety of baseline FEV1 values.27, 28 Moreover, baseline FEV1 (alone or in combination with other lung function attributes) does not predict whether or not people with COPD achieve the minimal important difference for exercise capacity, health status, fatigue, anxiety and/or depression following PR.5, 7, 29-31 So, baseline FEV1 cannot be used to identify responders or non-responders. To conclude, FEV1 has no added to value as selection criterion for PR in people with COPD. Therefore, the respiratory community needs to foster adequate referral to exercise-based interventions, including center-based pulmonary rehabilitation, without using FEV1 as a referral criterion.32 Consequently, an interdisciplinary assessment must go far beyond the regular lung function tests, and should include also patients' physical, emotional and social status.18, 33 Frits M. E. Franssen has received grants and personal fees from AstraZeneca, and personal fees from Boehringer Ingelheim, Chiesi, GSK and Novartis. Martijn A. Spruit received grant from Netherlands Lung Foundation, Stichting Astma Bestrijding, all paid to Ciro. Moreover, he received grants and/or personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi and Teva, all paid to Ciro.

Responsiveness of the late life disability instrument to pulmonary rehabilitation in people with COPD

PurposeTo establish the responsiveness of the disability component of the Late Life Function and Disability Instrument (LLDI) and its Computer Adaptive Test (LLDI-CAT) in people with chronic obstructive pulmonary disease (COPD). MethodParticipants completed the LLDI, LLDI-CAT and measures of physical function, health-related quality of life (HRQOL) and symptom severity before and after pulmonary rehabilitation (PR), and global rating of change (GRC) scales at the end of PR. Responsiveness was explored by calculating correlations between LLDI and LLDI-CAT change scores and change scores on the other measures, and calculating the area under the receiver operating characteristic curve (AUC) for the ability of the LLDI and LLDI-CAT to discriminate between participants who were improved versus unchanged. We hypothesized fair correlations (−0.3 to −0.5 or 0.3 to 0.5) with other measures and considered an AUC≥0.7 acceptable. Minimal important differences (MIDs) were estimated using anchor- and distribution-based approaches. ResultsFifty participants (mean (SD) age 69.8 (7.9) years) completed the study. Only the limitation dimension of the LLDI showed improvement at follow-up (z = 2.4, p = 0.018) and was able to discriminate between participants who were improved versus unchanged (AUC 0.7 (95% CI 0.6–0.9)). Correlations between change scores were as hypothesized between the participation measures and measures of at least two other constructs. ConclusionThis study provides MID values for the LLDI and LLDI-CAT to support their clinical application. The limitation dimension of the LLDI appears to be particularly responsive to PR in people with COPD.

Study within a review (SWAR).

Study within a review (SWAR).

Efficacy of Repeating Pulmonary Rehabilitation in People with COPD: A Systematic Review.

BackgroundPulmonary rehabilitation is an effective intervention for people with chronic obstructive pulmonary disease (COPD). People with COPD undertake repeat programs, but synthesis of evidence regarding such practice has not been undertaken. The aim of this systematic review was to establish the effects of repeating pulmonary rehabilitation subsequent to an initial program in people with COPD.MethodsStudies where participants with COPD undertook >1 pulmonary rehabilitation program were included, incorporating RCT (randomized controlled trial) and non-randomized studies. Electronic database searches were undertaken. Two authors independently undertook study identification, data extraction and risk of bias assessment. The primary outcome was health-related quality of life (HRQoL); secondary outcomes were exercise capacity, hospitalizations and exacerbations, adherence, mortality and adverse events. Narrative synthesis was undertaken for clinically heterogeneous trials. Data from RCTs and non-randomized studies were not combined for analysis.ResultsTen included studies (2 RCTs) involved 907 participants with COPD (n=653 had undertaken >1 program). The majority of studies were at high risk of bias. One RCT (n=33) reported no difference in HRQol after a repeat program vs usual care following exacerbation (Chronic Respiratory Disease Questionnaire dyspnea domain score MD 0.4, 95% CI −0.5 to 3). In stable patients, clinically important and statistically significant improvements in HRQoL and exercise capacity were reported after repeat programs, but of a smaller magnitude than initial programs. There was evidence for reductions in exacerbations and hospitalizations, and shorter hospital length of stay for patients who repeated a program twice in 12 months compared to those who repeated once. No data for mortality or adverse events were available.ConclusionThis systematic review provides limited evidence for benefits of repeating pulmonary rehabilitation in people with COPD, including improved HRQoL and exercise capacity, and reduced hospitalizations. However, most studies have high risk of bias, which reduces the certainty of these conclusions.Study RegistrationPROSPERO (CRD42020215093).

Enhancing and assessing fidelity in the TANDEM (Tailored intervention for ANxiety and DEpression Management in COPD) trial: development of methods and recommendations for research design

BackgroundDevelopment of complex interventions for management of chronic conditions has become increasingly common, with guidance now provided. Fidelity (whether the intervention is designed, delivered and received as intended) is critical to understanding if, and how an intervention works (or not). However, methods for achieving this are still evolving. This study describes the methods used in the TANDEM trial – a large multicentre study evaluating the impact of a cognitive behavioural intervention preceding routine pulmonary rehabilitation for people with chronic obstructive pulmonary disease and anxiety and or depression. Results for enhancement and training aspects of fidelity, are presented.MethodsUsing the National Institute for Health Behaviour Change Consortium (NIH BCC) framework of fidelity, a set of enhancement strategies and a fidelity measurement strategy were developed with input from a multidisciplinary team. The Cognitive First Aid Rating Scale (CFARS) was used to assess Facilitator (the respiratory professional delivering TANDEM) therapeutic competence at the end of the initial training and throughout treatment delivery (on a randomly selected set of cases). A TANDEM specific treatment adherence measure was developed following previously recommended procedures. Together these (the CFARS and adherence measure) comprised the TANDEM treatment delivery fidelity tool.ResultsHiring of respiratory professionals to the initial training programme was successful, with 44% of those expressing initial interest in being a Facilitator successfully completing the process. Video recordings of potential Facilitators conducting standardized patient role plays at the end of the initial training demonstrated fidelity of training.ConclusionsAddressing fidelity in complex intervention trials is a time and resource intensive process but has significant potential to increase understanding of results and strengthen the evidence base for effective interventions. By defining a full fidelity assessment method prior to analysis we aimed to minimise bias when interpreting results.Trial registrationISRCTN59537391. Registered on 20 March 2017. Trial protocol version 6.0, 22 April 2018. Process evaluation protocol version 4.0, 1 November 2020.

간질성 폐질환 환자의 호흡재활

Interstitial lung disease (ILD) is a heterogenous group of about 200 chronic respiratory diseases characterized by exertional dyspnea, significant exercise limitation, decline in health-related quality of life (HRQL). Pulmonary rehabilitation (PR) is well established in patients with chronic obstructive pulmonary disease (COPD) to improve exercise capacity, dyspnea and HRQL. There is increasing evidence of comparable effects of PR in people with ILD. This review will provide an overview of constitution and the current evidence to support pulmonary rehabilitation in patients with interstitial lung diseases (ILD), in enhancing quality of life and exercise capacity using exercise training and education. Further investigation includes identifying optimal exercise training regimens to extent duration of benefit, educational topics, and intervention tailored to the complex need to people are required.

The Effect of Tele-Rehabilitation on Improving Physical Activity in Patients with Chronic Obstructive Pulmonary Disease: A Systematic Review of Randomized Controlled Clinical Trials

Introduction: Physical activity is a promising strategy to maintain the benefits gained after completing conventional pulmonary rehabilitation in people with chronic obstructive pulmonary disease (COPD). Proponents of tele-rehabilitation and physiotherapy see the use of communication and information technologies as a way to increase access and increase care continuity. Therefore, the purpose of this study is a systematic review of randomized clinical trial and randomized controlled trials to investigate the effect of tele-rehabilitation on improving the physical activity of patients with COPD.Method: A systematic review was conducted in randomized controlled clinical trial studies without time limit by searching for keywords in the title, abstract and study keywords in the valid scientific databases Embase, Web of Science, Scopus, PubMed on October 20, 2021. The quality of the studies was assessed using the Joanna Briggs Institute(JBI)checklist; Studies with a score above 7 were analyzed. This study was conducted according to the Preferred reporting Items for systematic reviews and meta-analysis(PRISMA).Results: A total of 83 articles were identified after removing duplicates. After screening the full text of the articles, 10 studies met the inclusion criteria. Studies were classified into two categories: randomized trial (6.10, 60%) and randomized clinical trial (4.10, 40%). Input studies included 979 participants. The duration of intervention in each study ranged from 8 weeks to 18 months. The technologies used included video conferencing (1.10, 10%), cloud-based platform (1.10, 10%), mobile application (1.10, 10%) and telephone calls (6.10, 60%). In (6.10, 60%) of the studies, tele-rehabilitation interventions had similar improvements in both control (face-to-face) and intervention (tele- technology) groups. However, in (4.10, 40%) of the studies, the intervention group reported a significant improvement compared to the control group.Conclusion: The results of the present systematic review showed that although in most studies tele-rehabilitation interventions have the same results as traditional interventions, a well-designed tele-rehabilitation program to improve the physical activity of patients with COPD can supplement or replace the program. It is a traditional rehabilitation and improves the patient's health.

Long-Term Maintenance Strategies after Pulmonary Rehabilitation: Perspectives of People with Chronic Respiratory Diseases, Informal Carers, and Healthcare Professionals.

Pulmonary rehabilitation (PR) is an effective intervention for people with chronic respiratory diseases (CRD); however, its effects fade after 6–12 months. Community-based strategies might be valuable to sustain PR benefits, but this has been little explored. People with CRD, informal carers, and healthcare professionals (HCPs) were recruited from pulmonology appointments of two local hospitals, two primary care centres, and one community institutional practice and through snowballing technique. Focus groups were conducted using a semi-structured guide. Data were thematically analysed. Twenty-nine people with CRD (24% female, median 69 years), 5 informal carers (100% female, median 69 years), and 16 HCPs (75% female, median 36 years) were included. Three themes were identified: “Maintaining an independent and active lifestyle” which revealed common strategies adopted by people with “intrinsic motivation and professional and peer support” as key elements to maintain benefits, and that “access to information and partnerships with city councils’ physical activities” were necessary future steps to sustain active lifestyles. This study suggests that motivation, and professional and peer support are key elements to maintaining the benefits of PR in people with CRD, and that different physical activity options (independent or group activities) considering peoples’ preferences, should be available through partnerships with the community, namely city councils.

Beneficial Effect of Water-Based Exercise Training on Exercise Capacity in COPD Patients-a Pilot Study.

Background: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable condition, characterized by persistent airflow limitation. Exercise training is a core component of pulmonary rehabilitation in people with COPD. Water-based exercise has been studied, but it remains unclear whether water-based exercise program leads to the improvement in respiratory function, muscle strength, balance ability, and exercise capacity. We aim to study the effect of an 8-week water-based exercise program on respiratory function, muscle strength, balance ability, and exercise capacity in people with COPD.Methods: Fourteen stable COPD participants (FEV1 56.8 ± 24.6%pred) were recruited and randomized into a water-based exercise or a land-based exercise group. Both groups were trained for 8 weeks, two sessions per week. Pulmonary function, respiratory muscle strength, peripheral muscle strength, balance ability, exercise capacity [6-min walking test (6MWT), incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT)] were assessed at baseline and at the end of the program. ANCOVA was used to conduct between-group comparisons of outcomes after adjusting for pre-intervention values.Results: Baseline characteristics of participants were not significantly different between the two groups (p ≥ 0.05). After the 8-week training program, participants in the intervention group achieved larger gains in ESWT (Δ663.4 ± 279.5 vs. Δ45.4 ± 93.2 s, p = 0.001). In addition, maximal inspiratory pressure (MIP) was significantly increased more in the intervention group (Δ11.1 ± 7.8 vs. Δ1.1 ± 5.7 cmH2O, p = 0.026). However, no significant differences in pulmonary function, peripheral muscle strength, balance ability variables, 6MWD (p = 0.248), and ISWT (p = 0.506) were observed between the two groups.Conclusions: The water-based exercise program could be recommended to the COPD rehabilitation program for improving the endurance exercise capacity and inspiratory muscle strength.Clinical Trial Registration: www.thaiclinicaltrials.org, identifier: TCTR20210125005.

Telerehabilitation for chronic respiratory disease: a randomised controlled equivalence trial

RationalePulmonary rehabilitation is an effective treatment for people with chronic respiratory disease but is delivered to <5% of eligible individuals. This study investigated whether home-based telerehabilitation was equivalent to centre-based...

What are the effects of pulmonary rehabilitation for people with interstitial lung disease?

What are the effects of pulmonary rehabilitation for people with interstitial lung disease?

Feasibility, tolerance and effects of adding impact loading exercise to pulmonary rehabilitation in people with chronic obstructive pulmonary disease: study protocol for a pilot randomised controlled trial

BackgroundChronic obstructive pulmonary disease (COPD) is a disorder linked with a multitude of extra pulmonary manifestations (also known as treatable traits), including low bone mineral density (BMD). To date, no specific guidelines exist for the management of BMD in this population. Impact loading exercise has been identified as an intervention that improves or maintains BMD in other populations. However, the feasibility of and tolerance to impact loading exercise has not been tested in people with COPD. The aim of the proposed study will be to investigate the feasibility and tolerance of adding impact loading exercise to a standard pulmonary rehabilitation programme (PRP) in people with COPD and report its effects on bone health, balance and falls risk.MethodsThis is a protocol for a pilot feasibility and tolerance randomised controlled trial (RCT). Fifty-eight people with COPD will be randomly allocated, on a 1:1 ratio, to either the experimental or control group. Initially, participants in both groups will complete a standard 8-week (twice-weekly) PRP followed by a 32-week period of maintenance exercises. Over the initial 8-week period, participants allocated to the experimental group will also undertake targeted lower limb resistance exercises and commence a programme of impact loading exercises (e.g. bounding and drop jumps). On completion of the initial 8-week PRP, in addition to the standard maintenance exercises, participants in the experimental group will continue with home-based impact loading exercises, four times a week, for the extra 32 weeks. The primary outcome of this study is feasibility of and tolerance to impact loading exercises. Feasibility will be measured using data collected pertaining to recruitment, withdrawal and completion. Adherence to the exercises will be collected using exercise logs. Tolerance to the exercises will be determined using outcomes to assess pain, recording any adverse effects such as a fall and feedback from the participants in semi-structured interviews on completing of the trial. The effects of the 40-week experimental intervention on bone health, balance and falls risk will be reported.DiscussionThis pilot RCT will test the feasibility and tolerance of an intervention that has never been trialed in people with COPD. It will also provide initial information regarding the size of the effect this intervention has on outcomes such as BMD, balance and falls risk. These data will be critical when designing a definitive RCT to advance this area of research.Trial registrationAustralian and New Zealand Clinical Trials Registry (ANZCTR): 12620001085965 (20/10/2020)

Home-based pulmonary rehabilitation in people with bronchiectasis: a randomised controlled trial.

AimTo investigate the short- and long-term effects of home-based pulmonary rehabilitation (HBPR) on functional capacity, quality of life, peripheral muscle strength, dyspnoea and daily physical activity in people with bronchiectasis.MethodsRandomised controlled trial with 63 participants with bronchiectasis. The HBPR group performed three sessions per week for 8 weeks (aerobic exercise: step training for 20 min; resistance training: exercises for quadriceps, hamstrings, deltoids and biceps brachii using elastic bands). The control group received a recommendation to walk at moderate intensity, three times per week. A weekly phone call was conducted for all participants, and the HBPR group received a home visit every 15 days. The primary outcome was distance in the incremental shuttle walk test (ISWT). Secondary outcomes were time in the endurance shuttle walk test (ESWT), number of steps in the incremental step test, quality of life, quadriceps muscle strength and daily physical activity. Measures were taken before and after intervention and 6 months later.ResultsAfter the intervention, the HBPR group had increased ISWT distance compared with the control group with between-group difference 87.9 m (95% CI 32.4–143.5 m). In addition, between-group differences were found in the ESWT, incremental step test, quality of life and quadriceps muscle strength, favouring the HBPR group. After 6 months, no differences were observed between the groups.ConclusionHBPR is an effective alternative offering of pulmonary rehabilitation for people with bronchiectasis. However, the programme was not effective in maintaining the benefits after 6 months of follow-up.

Pulmonary rehabilitation for interstitial lung disease.

Pulmonary rehabilitation for interstitial lung disease.