Pulmonary rehabilitation improves exercise tolerance in patients with bronchiectasis.

Question: For patients with bronchiectasis, does pulmonary rehabilitation either with or without inspiratory muscle training (IMT) improve exercise tolerance? Design: Randomised controlled trial. Setting: Outpatient-based pulmonary rehabilitation program of a UK hospital. Patients: Patients with bronchiectasis confirmed by highresolution computer tomography. Exclusion criteria included concomitant emphysema, an acute exacerbation in the previous six weeks, long-term oral corticosteroid use, and significant co-morbidities. Thirty-two patients were randomised to pulmonary rehabilitation plus IMT (PRIMT) (n = 12), pulmonary rehabilitation plus sham IMT (PR-Sham) (n = 11), or a control group with no intervention (n = 9). Interventions: Pulmonary rehabilitation consisted of exercise training and multidisciplinary education sessions for eight weeks. Exercise consisted of three 45minute periods per week with a target exercise intensity of 80% of the peak heart rate achieved on an initial maximal incremental exercise test. Two sessions per week were performed at the hospital and involved cycling, treadmill walking, and stair climbing. A third session of walking was performed at home, using the Borg dyspnoea scale to guide intensity. IMT was performed for 15 minutes twice daily over the eight-week period using a pressure threshold Pulmonary rehabilitation improves exercise tolerance in patients with bronchiectasis