Dos Santos Daniele Oliveira, de Souza Hugo Celso Dutra, Baddini-Martinez José Antônio, Ramos Ercy Mara Cipulo, Gastaldi Ada Clarice
Department of Physiotherapy Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo Department of Physiotherapy, São Paulo State University, Presidente Prudente, São Paulo, Brazil.
Medicine (Baltimore). 2018 Feb;97(7):e9768. doi: 10.1097/MD.0000000000009768.
Bronchiectasis is characterized by pathological and irreversible bronchial dilatation caused by the inefficient mucus and microorganism clearance and progression of inflammatory processes. The most frequent characteristic is the increase in bronchial mucus production resulting in slower transport and damage to the mucociliary transport.
To evaluate the effects of exercise on mucus transport, inflammation, and resistance of the respiratory and autonomic nervous systems and subsequent effects on quality of life in patients with bronchiectasis who are enrolled in a pulmonary rehabilitation program.
Sixty subjects of both sexes between 18 and 60 years (30 volunteers with clinically stable bronchiectasis and 30 healthy volunteers) will be included. Participants with chronic obstructive pulmonary disease, decompensated cardiovascular or metabolic diseases, neuromuscular and musculoskeletal diseases, and active smokers will be excluded. Volunteers will be randomly allocated to the pulmonary rehabilitation or control groups. The primary outcomes will be nasal transport time as evaluated by nasal saccharin transport time, analysis of nasal lavage, enzyme immunoassay of exhaled expiration, and analysis of the mucus properties. The secondary outcomes will include pulmonary function tests, impulse oscillometry, heart rate variability analysis, and quality of life questionnaires.
In addition to the benefits for patients already described in the literature, the additional benefit of mucus removal may contribute to optimizing treatments and better control of the disease.
This protocol could provide new information about the unclear mechanisms regarding exercise to aid in the removal of secretions.
支气管扩张症的特征是由于黏液和微生物清除效率低下以及炎症过程进展导致的病理性和不可逆的支气管扩张。最常见的特征是支气管黏液分泌增加，导致转运减慢和对黏液纤毛转运的损害。
评估运动对参加肺康复计划的支气管扩张症患者的黏液转运、炎症、呼吸和自主神经系统阻力的影响，以及对生活质量的后续影响。
将纳入60名年龄在18至60岁之间的男女受试者（30名临床稳定的支气管扩张症志愿者和30名健康志愿者）。患有慢性阻塞性肺疾病、失代偿性心血管或代谢疾病、神经肌肉和肌肉骨骼疾病以及现役吸烟者将被排除。志愿者将被随机分配到肺康复组或对照组。主要结局指标将包括通过鼻内糖精转运时间评估的鼻腔转运时间、鼻腔灌洗分析、呼出气酶免疫测定以及黏液特性分析。次要结局指标将包括肺功能测试、脉冲振荡法、心率变异性分析和生活质量问卷。
除了文献中已描述的对患者的益处外，清除黏液的额外益处可能有助于优化治疗并更好地控制疾病。
该方案可为有关运动辅助清除分泌物的不明机制提供新信息。
