TY - JOUR
T1 - Current physiotherapy practice for adults with bronchiectasis
T2 - Data from the Australian bronchiectasis registry
AU - Webb, Elizabeth M.
AU - Holland, Anne E.
AU - Chang, Anne B.
AU - Burr, Lucy
AU - Holmes-Liew, Chien Li
AU - King, Paul T.
AU - Middleton, Peter G.
AU - Morgan, Lucy
AU - Thomson, Rachel M.
AU - Wong, Conroy
AU - Lee, Annemarie L.
PY - 2024/11
Y1 - 2024/11
N2 - Background: Although airway clearance techniques (ACTs) and physical exercise are recommended for adults with bronchiectasis, there is little data on current practice and limited guidance predicting clinical approach. Objective: This study aimed to describe current ACT and exercise practice recorded by patients, and identify predictors of regular ACTs, ACT modalities and exercise. Methods: Physiotherapy-specific interventions, quality of life (Quality-of-Life Bronchiectasis questionnaire, QOL-B), demographics and disease severity were extracted from the Australian Bronchiectasis Registry. Multivariate analyses were undertaken to identify predictors of undertaking ACTs or exercise. Results: We included 461 patients; median age of 72 years (interquartile range 64–78 years). Regular ACT use was recorded by 266 (58 %) patients; the active cycle of breathing technique (n = 175, 74 %) was the most common technique. Regular exercise use was recorded by 213 (46 %) patients, with walking the most common form of exercise. A pulmonary rehabilitation referral was made for 90 (19.5 %) of patients. Regular ACT use was associated with a higher treatment burden on QOL-B (Odds ratio (OR) = 0.97, 95 % confidence interval (CI) 0.96 to 0.99). Regular exercise was more likely amongst patients with severe bronchiectasis compared to those with mild disease (OR = 9.46, 95 % CI 1.94 to 67.83) and in those with greater physical function on the QOL-B (OR = 1.02, 95 % CI 1.01 to 1.04). Conclusion: Approximately half the adults in the registry report regular ACT or exercise; QOL and disease severity predict this engagement. This knowledge may guide the tailoring of ACTs and exercise prescription to optimise physiotherapy management in adults with bronchiectasis.
AB - Background: Although airway clearance techniques (ACTs) and physical exercise are recommended for adults with bronchiectasis, there is little data on current practice and limited guidance predicting clinical approach. Objective: This study aimed to describe current ACT and exercise practice recorded by patients, and identify predictors of regular ACTs, ACT modalities and exercise. Methods: Physiotherapy-specific interventions, quality of life (Quality-of-Life Bronchiectasis questionnaire, QOL-B), demographics and disease severity were extracted from the Australian Bronchiectasis Registry. Multivariate analyses were undertaken to identify predictors of undertaking ACTs or exercise. Results: We included 461 patients; median age of 72 years (interquartile range 64–78 years). Regular ACT use was recorded by 266 (58 %) patients; the active cycle of breathing technique (n = 175, 74 %) was the most common technique. Regular exercise use was recorded by 213 (46 %) patients, with walking the most common form of exercise. A pulmonary rehabilitation referral was made for 90 (19.5 %) of patients. Regular ACT use was associated with a higher treatment burden on QOL-B (Odds ratio (OR) = 0.97, 95 % confidence interval (CI) 0.96 to 0.99). Regular exercise was more likely amongst patients with severe bronchiectasis compared to those with mild disease (OR = 9.46, 95 % CI 1.94 to 67.83) and in those with greater physical function on the QOL-B (OR = 1.02, 95 % CI 1.01 to 1.04). Conclusion: Approximately half the adults in the registry report regular ACT or exercise; QOL and disease severity predict this engagement. This knowledge may guide the tailoring of ACTs and exercise prescription to optimise physiotherapy management in adults with bronchiectasis.
KW - Airway clearance techniques
KW - Airway clearance therapy
KW - Bronchiectasis
KW - Exercise
KW - Physical activity
KW - Physiotherapy
KW - Pulmonary rehabilitation
UR - http://www.scopus.com/inward/record.url?scp=85202170542&partnerID=8YFLogxK
U2 - 10.1016/j.rmed.2024.107777
DO - 10.1016/j.rmed.2024.107777
M3 - Article
AN - SCOPUS:85202170542
SN - 0954-6111
VL - 233
SP - 1
EP - 8
JO - Respiratory Medicine
JF - Respiratory Medicine
M1 - 107777
ER -