Effects of Expiratory Muscle Training Added to Pulmonary Rehabilitation in Patients With Bronchiectasis

Condition(s) studied

Investigational drug(s) / intervention(s)

pulmonary rehabilitation: Participants will undergo a standard pulmonary rehabilitation program including supervised aerobic exercise, resistance training, breathing exercises, and patient education. The program will be conducted three times per week over the intervention period in accordance with current pulmonary rehabilitation guidelines.

Expiratory muscle training: Expiratory muscle training will be performed using an adjustable PowerBreathe EX1 expiratory muscle training device. The initial training load will be set at 30-40% of the participant's maximal expiratory pressure (MEP) and will be progressively increased by 5-10% on a weekly basis. Training sessions will be conducted three days per week, consisting of two sets per day, with each set including 10-15 repetitions.

Study summary

This randomized, single-blind, parallel-group controlled trial aims to investigate the effects of expiratory muscle training added to standard pulmonary rehabilitation on respiratory muscle strength, pulmonary function, cough effectiveness, exercise capacity, dyspnea perception, and quality of life in patients with non-cystic fibrosis bronchiectasis. Eligible patients aged 18-70 years with stable disease will be randomly assigned to either a pulmonary rehabilitation-only group or a pulmonary rehabilitation combined with expiratory muscle training group. Outcomes will be assessed at baseline and after completion of the intervention period.

Eligibility

Primary outcome measure(s)

• Functional capacity — Baseline and 8 weeks
  Functional capacity will be evaluated using the 6-minute walk test (6MWT) performed on a 30-meter corridor in accordance with ATS guidelines. Total walking distance will be recorded as the primary outcome of the test.
• Maximum Inspiratory Pressure (MIP) — Baseline and 8 weeks
  Respiratory muscle strength will be assessed using maximum inspiratory pressure (MIP), measured with a portable mouth pressure device according to standard guidelines. Higher values indicate better inspiratory muscle function.
• Maximum Expiratory Pressure (MEP) — Baseline and 8 weeks
  Respiratory muscle strength will be assessed using maximum expiratory pressure (MEP), measured with a portable mouth pressure device according to standard guidelines. Higher values indicate better expiratory muscle function.
• Forced Vital Capacity (FVC) — Baseline and 8 weeks
  Forced Vital Capacity (FVC) will be measured using a portable spirometer calibrated according to American Thoracic Society (ATS) and European Respiratory Society (ERS) standards. The best result from at least three attempts will be recorded.
• Forced Expiratory Volume in 1 Second (FEV₁) — Baseline and 8 weeks
  Forced Expiratory Volume in 1 second (FEV₁) will be measured using a portable spirometer calibrated according to ATS/ERS standards. The best result from at least three attempts will be recorded.
• FEV₁/FVC Ratio — Baseline and 8 weeks
  FEV₁/FVC ratio will be calculated from spirometry results. The best result from at least three attempts will be recorded.
• Cough Strength (Peak Cough Flow, PCF) — Baseline and 8 weeks
  Peak Cough Flow (PCF) will be measured using a peak flow meter.

Trial sites (1)

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