ORIGINAL RESEARCH article
Front. Rehabil. Sci.
Sec. Pulmonary Rehabilitation
Effectiveness of exercise training in people with non-cystic fibrosis bronchiectasis with and without COPD
Michele Vitacca 1
Mara Paneroni 1
Antonio Spanevello 2
MAURO CARONE 3
Giuseppina Cassetti 4
Cinzia Lastoria 5
Mauro Maniscalco 6
Armando Capelli 7
Nicolino Ambrosino 8
1. Istituti Clinici Scientifici Maugeri SpA IRCCS Lumezzane, Lumezzane, Italy
2. Istituti Clinici Scientifici Maugeri SpA IRCCS Tradate, Tradate, Italy
3. Istituti Clinici Scientifici Maugeri SpA IRCCS Bari, Bari, Italy
4. Istituti Clinici Scientifici Maugeri SpA IRCCS Milano, Milan, Italy
5. Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Italy
6. Istituti Clinici Scientifici Maugeri SpA IRCCS Telese, Telese Terme, Italy
7. Istituti Clinici Scientifici Maugeri SpA IRCCS Veruno, Veruno, Italy
8. Istituti Clinici Scientifici Maugeri SpA IRCCS Montescano, Montescano, Italy
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Abstract
Background and aim. Non-Cystic Fibrosis (CF) bronchiectasis is associated with reduced exercise tolerance and symptoms such as dyspnea and fatigue, impairing functional capacity and limiting physical activity. In addition to airway clearance techniques, pulmonary rehabilitation (PR), including aerobic and resistance training, is recommended in these individuals. This retrospective, multicentric study covering a ten-year period compared in non-CF bronchiectasis people with and without COPD the effectiveness of PR, including exercise training, on exercise tolerance (primary objective) and other patient-centered outcomes. Measurements. Before and after PR, the following assessments had been performed: Six-minute walking test (6MWT), Barthel Index (BI), Barthel Index dyspnea (BId), COPD assessment test (CAT), Short physical performance battery (SPPB). Results. 125 participants without and 1346 with concomitant COPD were studied. Non-COPD bronchiectasis was more prevalent in females, showed a higher association with asthma, whereas Chronic Respiratory Failure (CRF) and pneumonia were more prevalent in COPD-related bronchiectasis, resulting in more prevalent referral from acute care hospitals or need for oxygen therapy. All baseline outcome measures, except CAT, were worse in people with concomitant COPD. After PR, 6MWT improved significantly in both groups (by 39 (11-70) and 40 (10-75) meters for non-COPD and COPD-related bronchiectasis, respectively, p=0.7469), without any between-group difference. The other outcome measures also improved significantly in both groups. The proportions of participants reaching the minimal clinically important difference in assessed outcomes were not significantly different between the studied populations. Conclusion. Pulmonary rehabilitation, including exercise training, yields equivalent benefits in exercise capacity and patient-reported outcomes in non-CF bronchiectasis people with or without COPD. Our results suggest the routine clinical provision of PR to people with non-CF bronchiectasis, regardless of concomitant COPD.
Summary
Keywords
COPD, Dyspnea, Exercise Tolerance, Health Status, Pulmonary Rehabilitation
Received
09 December 2025
Accepted
09 February 2026
Copyright
© 2026 Vitacca, Paneroni, Spanevello, CARONE, Cassetti, Lastoria, Maniscalco, Capelli and Ambrosino. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Michele Vitacca
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