Background and Purpose: Bronchiectasis is a chronic lung disease defined by permanent, abnormal dilation of the bronchi and accompanied by chronic airway infection which leads to airway inflammation. Bronchiectasis is progressive and leads to a cycle of worsening pulmonary damage. Pulmonary rehabilitation, including progressive gait training, cycling, and stair climbing, is often utilized as treatment for this condition. However, there has been little research conducted on its effectiveness for bronchiectasis. The purpose of this case report is to examine physical therapy (PT) management, utilizing pulmonary rehabilitation with incorporated balance training, for a geriatric patient with bronchiectasis. Description: The patient was a 91-year-old female who was recommended to home health PT after hospitalization following exacerbation of bronchiectasis. The initial PT evaluation revealed a complex medical history with impairments in endurance, balance, and sensation. PT was provided in the assisted living facility, where the patient resided. Treatments included progressive gait and stair training, static and dynamic balance training, deep breathing and scapular retraction exercises, and chest percussion. Outcome measures performed included the Tinetti Performance Oriented Mobility Assessment (POMA), Timed Up and Go (TUG), Four Square Step Test (4SST), and the Functional Gait Assessment (FGA). Outcomes: POMA score improved by 32% and FGA by 33%. TUG improved by 7.07 seconds. Time taken to complete the 4SST increased by 0.70 seconds with the patient progressing from contact guard assist to supervision to safely complete the test. Significant improvement towards goals was demonstrated by the ability to ascend and descend two flights of stairs and ambulate approximately half a mile on the sidewalk. Discussion: Pulmonary rehabilitation in combination with balance training appeared to benefit a 91-year-old patient’s physical function and contribute to her potential for participation in social activities in the community.
Quarles, Megan Witherow, "Management Of A Patient With Bronchiectasis Using Pulmonary Rehabilitation And Balance Training: A Case Report" (2016). Case Report Papers. 64.