Effectiveness of chest physiotherapy and pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis: a narrative review

  • Sara Annoni | sara.annoni@asst-monza.it Physical Medicine and Rehabilitation Unit, San Gerardo Hospital, Monza, Italy.
  • Angela Bellofiore Pulmonology and Adult Cystic Fibrosis Center, Department of Internal Medicine, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • Elena Repossini Don Gnocchi Foundation, Palazzolo Institute, Milan, Italy.
  • Marta Lazzeri Department of Cardiothoracic and Vascular Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Antonello Nicolini Respiratory Diseases Unit, Hospital of Sestri Levante, Genoa, Italy.
  • Paolo Tarsia Pulmonology and Adult Cystic Fibrosis Center, Department of Internal Medicine, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Abstract

Respiratory physiotherapy and rehabilitation are important therapeutic options in non-cystic fibrosis bronchiectasis (NCFB). The aims of this review of clinical trials were to evaluate the safety and the effects on physiologic and clinical outcomes of airway clearance techniques (ACTs) and rehabilitation in NCFB patients, in comparison to usual care. The search was performed on March 2018 by using PubMed and PeDro databases. 33 studies were selected. The use of ACTs for NCFB were effective in increasing sputum volume although no benefit in quality of life (QoL) or pulmonary exacerbations were observed. There were no differences in effectiveness between the several techniques used. Humidification and saline inhalation were able to aid airway clearance. Hypertonic solution (HS) was more effective than isotonic solutions (IS) in improving expectoration and sputum viscosity. Pulmonary rehabilitation (PR) was found to be associated with short term benefits in exercise capacity, dyspnea and fatigue. Exercise training seems to improve quality of life and lower exacerbation rate, but long-term data are not available. Further studies are necessary to identify the most feasible long-term outcomes such as QoL and exacerbation rate.

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Published
2020-02-12
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Section
Physiotherapy - Reviews
Keywords:
bronchiectasis, airway clearance, humidification, hypersaline inhalation, pulmonary rehabilitation
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How to Cite
Annoni, S., Bellofiore, A., Repossini, E., Lazzeri, M., Nicolini, A., & Tarsia, P. (2020). Effectiveness of chest physiotherapy and pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis: a narrative review. Monaldi Archives for Chest Disease, 90(1). https://doi.org/10.4081/monaldi.2020.1107

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