Evaluation of functional capacity, muscle function, lung function and quality of life in patients with bronchiectasis

Abstract

Introduction: Bronchiectasis is a chronic respiratory disease characterized pathologically by abnormal and permanent dilation of the bronchi, being caused mainly by the perpetuation of inflammatory processes and impaired removal of secretions. As a consequence, the disease directly affects the functional capacity and quality of life (QoL) of patients. Its etiology is nonspecific and represented by the final stage of several pathological processes. In Brazil, almost half of cases of bronchiectasis correspond to tuberculosis (TB) sequelae, unlike European countries where cases classified as idiopathic and non-TB post-infectious disease predominate. Objective: The objective of the present study was to evaluate the functional capacity of patients with post-TB bronchiectasis (PTBB) through the ADL-Glittre test (TGlittre), comparing them with patients with non-TB bronchiectasis (NPTBB) and
also to correlate these findings with lung function, muscle function, and QoL. Methods: This is a cross-sectional and observational study, with quantitative evaluation of sample data, in which 32 patients diagnosed with PTBB and 29 with NPTBB, of both genders and over 18 years old, were evaluated. Pulmonary function tests and measurements of handgrip strength (HGS) and quadriceps strength (QS) were performed. Additionally, these patients were submitted to the Short Form-36 questionnaire (SF-36). Results: As a result, both PTBB patients and NPTBB patients required much more time to perform TGlittre compared to predicted values, although they did not differ statistically from each other [152(124-200) vs. 145(117-179) % predicted, P=0.41]. Regarding pulmonary function tests, patients with PTBB had significantly lower values than patients with NPTBB, in forced vital capacity (FVC, 60 ± 14.5 vs. 78.2 ± 22.2 % predicted, P <0.001) and total lung capacity [TLC, 82 (66-95) vs. 93 (82-105) % predicted, P = 0.028]. In the PTBB group, FVC (P < 0.001) and QS (P = 0.001) were the only significant dependent variables for predicting TGlittre timing, explaining 71% of its variability. In the NPTBB group, maximal expiratory pressure (P = 0.001), residual volume/TLC ratio (P=0.002) and QS (P = 0.032) were the significant dependent variables to predict TGlittre time, explaining 73% of the its variability. Conclusion: Thus, patients with PTBB have poor performance on TGlittre that is similar to that of patients with NPTBB. Patients with PTBB have a greater reduction in lung volumes compared to patients with NPTBB. Furthermore, TGlittre performance in PTBB patients is largely explained by lung volume and QS. Our findings may provide important information for outcome measures in pulmonary rehabilitation programs in patients with bronchiectasis.