Fysioterapeuten 3-2021

VITENSKAPELIG ARTIKKEL 62 FYSIOTERAPEUTEN 3/21 Abstract Title: Evaluation of an interdisiplinary patient education day followed by individually tailored airway clearance therapy in patients with non-cf bronchiectasis: an intervention study Aim : To illuminate the concept of airway clearance techni- ques (ACT) as self-treatment, and to evaluate an interdis- ciplinary patient education day, followed by individually tailored airway clearance therapy with regard to quality of life (QoL) in patients with non-cystic fibrosis bronchiectasis (NCFB). Material and Methods : A pre- post single arm trial where patients with NCFB participated in a structured interdisciplinary patient education day, followed by three individual physiotherapy sessions with ACT. Patients were recruited and enrolled to the study from our pulmonary clinic from October 2017 to May 2019. Quality of life was assessed using St George’s Respiratory Questionnaire (SGRQ) at baseline and 6 months after participation in the patient education day. Results : Among 35 patients who were included 31 (87%) completed the study. Mean age; 60.1 ± 13.9, years; 71.4 % women, mean BMI; 23.7 ± 3.8, mean FVC (% of predicted); 90.4 ± 16.6, mean FEV1 (% of predicted); 79.8 ± 21. The mean change in SGRQ total score was -8.7, 95% confiden- ce interval (CI) -4.7 – -12.8 (p <0.001). In addition, there were statistically and clinically significant improvements in all domains of SGRQ; symptoms score, impact score and activity score, with mean changes of -8.9, -7.0 and -11.8, respectively (p < 0.005). Conclusion : One day of interdisciplinary patient education followed by individually tailored airway clearance therapy resulted in statistically and clinically significant improve- ments in QoL in patients with NCFB at six months. Keywords : Respiratory physiotherapy, quality of life, bronchiectasis. ikke i gang med fysioterapi før det hadde gått 4-6 uker. De fikk dermed ikke en tilpasset egenbehandlingsplan for se- kretmobilisering før etter en stund, og noen fikk infeksjon i mellomtiden. De fleste hadde også hyppigere infeksjoner i vinterhalvåret. Konklusjon Lungefysioterapi og optimal sekretmobilisering må sees i lys av fysiologiske prinsipper, og ikke være en oppskrift hvor «one size fits all». Dette gjør det utfordrende å utføre randomiserte kontrollerte studier for å evaluere effekt av sekretmobiliserende tiltak. Tverrfaglig poliklinisk under- visning og individuelt tilpasset LFT resulterte i statistisk og klinisk signifikant bedring i LK hos pasientene med bronkiektasier som møtte til kontroll etter seks måneder. Resultatene fra denne kvalitetssikringsstudien har ført til videreføring av dette tilbudet på OUS. Fremtidig forskning bør belyse bronkiektasipasienters opplevelser av indivi- duelt tilpasset LFT, samt beskrive hvilke tiltak pasientene opplever som nyttige for å oppnå effektiv, skånsom og selv- stendiggjørende sekretmobilisering. Takk Takk til Elizabeth Eskeland, Stine Henrikke Monsen, Marit Vold Heddan, Pål Leyell Finstad, Medisinsk klinikk, Oslo universitetssykehus. Referanser 1. (IPG/CF) IPGfCF. Physiotherapy for Respiratory Conditions – Glossary (2nd edn) https://www.ecfs.eu/ipg_cf/booklet2018 2. O’Neill K, O’Donnell AE, Bradley JM. Airway clearance, mucoactive therapies and pulmonary rehabilitation in bronchiectasis. Respirology 2019;24(3):227- 37. doi: 10.1111/resp.13459 3. Lee AL, Burge AT, Holland AE. Airway clearance techniques for bron- chiectasis. Cochrane Database Syst Rev 2015(11):CD008351. doi: 10.1002/14651858.CD008351.pub3 4. Hill AT, Sullivan AL, Chalmers JD, et al. British Thoracic Society Guideline for bronchiectasis in adults. 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