Publications (2)0 Total impact
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ABSTRACT: There is limited information about the benefits of pulmonary rehabilitation (PR) in patients with bronchiectasis. This study aimed to evaluate the effects of an out-patient PR program in patients with a primary diagnosis of bronchiectasis and to compare them with a matched COPD group who completed the same PR program. A retrospective review was conducted of patients with bronchiectasis or COPD who completed 6 to 8 weeks of PR at two tertiary institutions. The outcome measures were the 6-minute walk distance (6MWD) and Chronic Respiratory Disease Questionnaire (CRQ). Ninety-five patients with bronchiectasis completed the PR (48 male; FEV(1) 63  % predicted; age 67  years). Significant improvements in 6MWD (mean change 53.4 m, 95% CI 45.0 to 61.7) and CRQ total score (mean change 14.0 units, 95% CI 11.3 to 16.7) were observed immediately following PR. In patients with complete follow-up (n = 37), these improvements remained significantly higher than baseline at 12 months (20.5 m, 95% CI 1.4 to 39.5 for 6MWD; 12.1 points, 95% CI 5.7 to 18.4 for CRQ total score). The time trend and changes in the 6MWD and CRQ scores were not significantly different between the bronchiectasis and the COPD groups (all p > 0.05). This study supports the inclusion of patients with bronchiectasis in existing PR programs. Further prospective RCTs are warranted to substantiate these findings.Chronic Respiratory Disease 01/2011; 8(1):21-30.
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ABSTRACT: Guidelines for conducting the 6-minute walk test (6MWT) indicate that oxyhaemoglobin saturation (SpO( 2)) should not be monitored constantly during the test. The aim of this study was to determine whether the nadir SpO(2) differs from the end-6MWT SpO(2) in patients with chronic respiratory disease. A total of 86 subjects underwent the 6MWT according to a standardized protocol with continuous monitoring of SpO(2) by pulse oximeter. Comparison of nadir SpO(2) and end SpO(2) was made and the proportion of subjects with important desaturation according to each measure was determined. The effect of resting during the 6MWT on the likelihood of a significant difference between nadir and end SpO(2) was evaluated. A total of 29 subjects with chronic obstructive pulmonary disease (COPD; mean [SD] forced expiratory volume in 1 second [FEV(1)] 51 % predicted) and 57 with interstitial lung disease (ILD; TLCO 49 % predicted) were studied. Nadir SpO(2) was slightly lower than end-test SpO(2) (median 87% vs. 88%, p < 0.001) with differences ranging from 1% to 10%. Those who rested during the test (n = 14) were more likely to have a significant difference between nadir SpO(2) and end SpO(2) (p = 0.04). End SpO(2) did not accurately identify desaturation in 21% of subjects. No differences between COPD and ILD were observed. For most patients with chronic respiratory disease, the end SpO(2) and the nadir SpO( 2) are similar during the 6MWT. However, the end SpO(2) does not give an accurate estimate of nadir SpO(2) in patients who rest. Consideration should be given to the constant monitoring of SpO(2) during the 6MWT.Chronic Respiratory Disease 01/2011; 8(3):181-4.