Current physiotherapy practice for adults with bronchiectasis: Data from the Australian bronchiectasis registry
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(Published version)
Date
2024
Authors
Webb, E.M.
Holland, A.E.
Chang, A.B.
Burr, L.
Holmes-Liew, C.L.
King, P.T.
Middleton, P.G.
Morgan, L.
Thomson, R.M.
Wong, C.
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Journal article
Citation
Respiratory Medicine, 2024; 233:107777-1-107777-8
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Elizabeth M. Webb, Anne E. Holland, Anne B. Chang, Lucy Burr, Chien-Li Holmes-Liew, Paul T. King, Peter G. Middleton, Lucy Morgan, Rachel M. Thomson, Conroy Wong, Annemarie L. Lee
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Abstract
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, QOLB), 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.
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Available online 23 August 2024
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© 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).