Effects of exercise on secretion transport, inflammation, respiratory system resistance and quality of life in patients with bronchiectasis

Introduction: Bronchiectasis are characterized by abnormal, permanent and irreversible dilation of the bronchi. Cough with excessive production of secretion is the main symptom. Patients can benefit from specific physiotherapy techniques for secretion removal, as well as from exercises, however, few studies describe the mechanisms involved in the beneficial effects associated with this intervention. Objective: To evaluate the effects of exercise on the transport of secretions, inflammation and resistance of the respiratory system, autonomic nervous system and its repercussions on quality of life in patients with bronchiectasis. Methods: This is an RCT in which volunteers with bronchiectasis (BCQ: n=12) and healthy (SAU: n=9) participated in a Pulmonary Rehabilitation Program (PRP). Pulmonary function assessments were performed; saccharin transport time (TTS); exhaled fraction of nitric oxide (FENO); cardiopulmonary test (CPET); six-minute walk test (6MWT); maximal respiratory pressures test; heart rate variability (HRV) and quality of life (QL). Results: The initial comparison between the BCQ and SAU groups showed a difference between all the variables analyzed in the spirometry; in IOS between variables R5-R20, FRES and AX, p<0.02); in PE% (p=0.02) and maximum distance covered in the 6MWT (DMPTC6), p=0.0002, in the initial evaluation. The comparison before and after PRP showed no difference for the FENO, CPET and HRV variables. In the TTS assessment, 58% of the BCQ group reported tasting saccharin in the initial assessment, against 83% in the final assessment. In the BCQ group, there was a difference in DMPTC6 (p<0.001). Conclusion: As expected, PRP was effective in improving exercise tolerance in the BCQ group and this increase, greater than DMCI (35m), can directly impact ADLs in these patients. In addition, there was also an improvement in mucociliary transport, which contributes to greater effectiveness of the secretion removal mechanisms and improvement in the QoL of these patients. (AU)