Respiratory Physiotherapy for Patients With Bronchiectasis

Lifestyle habits

* Smoking status: yes/no * Former smoker: yes/no (defined as having given up smoking for ≥ 4 months).

Baseline

Characteristics of the pathological process: aetiology.

Post-infectious, inflammatory, immunological, congenital or other

Baseline

Radiological findings:

Confirmation of the diagnosis using high-resolution computed tomography, type of bronchiectasis and radiological extent.

Baseline

Clinical findings. Modified Medical Research Council Dyspnoea Scale

The Modified Medical Research Council (mMRC) Dyspnoea Scale is a tool for assessing the patient's sensation of breathlessness and is used to classify the severity of dyspnoea into five levels, ranging from zero - which indicates the absence of dyspnoea - to four, which represents severe dyspnoea that limits everyday activities.

Periprocedural.

Microbiological Analysis of Sputum

Types of bacteria and fungi found in sputum.

Periprocedural

Laboratory test.

C-reactive protein (CRP), measured in mg/L

Values recorded in the most recent laboratory test in the medical record at the time the respiratory physical therapy program begins.

Bronchiectasis severity scale: E-FACED

It is a multidimensional tool that enables the stratification of the risk of exacerbations, hospitalisations and mortality. It is valued exacerbations, spirometric data, age, pseudomonas colonisation, computed tomography extent and dyspnoea.Each variable is scored on a dichotomous scale, with a total range of increasing severity from 0 to 9 points, where 0-3 points indicate mild bronchiectasis, 4-6 points moderate bronchiectasis and 7-9 points severe bronchiectasis.

Periprocedural

Pharmacological treatment.

Corticosteroids, antibiotics, inhaled bronchodilators and saline solution.

Periprocedural

Comorbidities.

Bronchial colonisation and other pulmonary complications (sleep apnoea syndrome (OSA)), cardiovascular, neurological, gastrointestinal (hiatal hernia), rheumatic, oncological or osteoarticular conditions.

Baseline

Exacerbations of bronchiectasis

Number of hospital admissions prior to respiratory physiotherapy treatment

The year prior to the start of respiratory physiotherapy treatment

Exacerbations of bronchiectasis

Number of readmissions following respiratory physiotherapy treatment

From the end of treatment up to 1 year later.

Physiotherapy on the ward during hospitalisation

Yes /no

Periprocedural.

Characteristics of physiotherapy treatment. Type of treatment (by duration):

Physiotherapy treatment 1 (8 weeks, rehabilitation protocol comprising education, bronchial clearance, strength training and aerobic exercise): duration (8 weeks, yes/no), interruptions to the programme and the reason for each interruption. Physiotherapy treatment 2 (10 sessions comprising education, bronchial clearance and exercise): interruptions and reason for each interruption. Physiotherapy treatment 3 (1 session comprising education and bronchial clearance).

Periprocedural.

Treatment techniques used in the pulmonary rehabilitation programme (yes/no).

Health education (use of nebulisers.), bronchial clearance sessions, positive pressure exercises (Acapella, Shaker), use of a volumetric spirometer, therapeutic exercise, strength training, aerobic training.

Periprocedural.

Treatment compliance

Non-compliant category based on attendance records and adherence to sessions.

Periprocedural.

Lung function: spirometry.

Spirometry is a respiratory function test that measures respiratory flow rates and volumes, which are useful for the diagnosis and monitoring of respiratory conditions. The spirometry results recorded in the medical records are compared: those taken before and after physiotherapy treatment.

Periprocedural.

Strength of the inspiratory muscles.

Measuring maximum inspiratory pressures (MIP) allows the strength of the inspiratory muscles to be assessed. These are simple, quick and non-invasive measurements. They involve the patient generating the maximum inspiratory pressure, measured in cmH₂O (starting from residual volume), against an occluded system. MIP primarily assesses diaphragmatic strength and is of great clinical utility in the diagnosis and monitoring of conditions affecting the respiratory muscles.

Periprocedural

Strength of the expiratory muscles.

Measuring peak expiratory pressures (MEP) allows the strength of the expiratory muscles to be assessed. These are simple, quick and non-invasive measurements. They involve the patient generating maximum expiratory pressure (from total lung capacity) against an occluded system. MEP is measured in cmH₂O and primarily assesses the strength of the intercostal and abdominal muscles. MEP are of great clinical utility in the diagnosis and monitoring of conditions affecting the respiratory muscles.

Periprocedural

Physical and functional capacity: The six-minute walk test (6MWT)

The six-minute walk test (6MWT) is a functional assessment used to measure exercise capacity and the cardiorespiratory response to exertion under controlled conditions. It involves determining the maximum distance a person can walk on a flat surface over a period of six minutes. In addition, oxygen saturation is measured using pulse oximetry throughout the test. It is widely used to assess tolerance to physical exertion, monitor the progression of various respiratory conditions and estimate the functional prognosis of diseases in a clinical setting.

Periprocedural.

Physical and functional capacity : Sit-to-Stand Test (1STST)

The Sit-to-Stand Test is a test that assesses the functional strength of the lower limbs and involves the person sitting down and standing up from a chair as many times as possible in 1 minute .

Periprocedural.

Physical and functional capacity : submaximal cycle ergometer test.

A submaximal cycle ergometer test is a stress test carried out on a stationary bicycle in which the patient is not required to exert themselves to their maximum capacity. The aim is to assess the cardiovascular, respiratory and functional responses during moderate-intensity exercise. The following are measured: watts, the duration of the test and the reason for failure.

Periprocedural.

Physical and functional capacity: submaximal test on a treadmill

A submaximal treadmill test is a stress test carried out on a treadmill in which the patient walks at a moderate intensity, without reaching maximum exertion. Its aim is to assess the response to exercise and functional capacity in a safe manner. The duration of the test, the angle of inclination reached and the reason for giving up are measured.

Periprocedural

Clinical findings

An assessment is made as to whether the patient is experiencing a cough, sputum production or haemoptysis (yes/no) at the time of physiotherapy treatment.

Periprocedural.