Effect of professional physiotherapy on patients with non CF bronchiectasis – a preliminary study

Introduction:

Non CF bronchiectasis is a rising entity around the world with developing diagnostics and evolving treatments being researched in the past few years. It is a pathological final common pathway of different etiologies and a thorough evaluation of the patients should be sought to establish a specific diagnosis. The aim of our study was to evaluate the efficacy of professional respiratory physiotherapy on the patients in which a specific diagnosis was not established.

Method:

Eight young patients with bronchiectasis who are under follow up at our pulmonary center in Tel Hashomer were evaluated. Specific diagnoses such as Cystic Fibrosis, Primary Ciliary Dyskinesis and immunodeficiencies (in which physiotherapy is known to be mandatory) were excluded. We examined the pulmonary function tests of these patients before and after one year of individually tailored professional physiotherapy at our institution three times per week in addition to independent physiotherapy at home using incentive resistance devices such as TRI-GYM.

Results:

Mean age of the patients at time of referral was 17.9 years (+/- 6.2). Mean FEV1 before starting physiotherapy was 63.6% predicted (+/- 21.7%) and after a year of treatment 70.4% predicted (+/- 21.8%), P < 0.01 (see table & figure).

Conclusion:

We showed a significant improvement in pulmonary function tests which we assume are due to the individually tailored physiotherapy these patients received. Since most other therapies such as inhaled antibiotics, Azithromycin, mucolytic agents and inhaled corticosteroids were also used before referral to our center; the change in FEV1 can probably not be attributed to their use. This assumption should be investigated further.

References:

[1] Management of bronchiectasis in adults. Chalmers JD, Aliberti S, Blasi F. Eur Respir J. 2015 May;45(5):1446 – 62.

[2] Airway clearance techniques for bronchiectasis. Lee AL, Burge AT, Holland AE. Cochrane Database Syst Rev. 2015 Nov 23;11