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Updated: Sep 27, 2025

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Bronchiectasis - Exercise as Therapy (BREATH): rationale and study protocol for a multi-center randomized controlled

Taryn Jones1, Kerry-Ann F O'Grady1, Vikas Goyal2,3,4

  • 1Queensland University of Technology, Brisbane, QLD, Australia.

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Summary

This study investigated a play-based exercise program for children with bronchiectasis (BE), finding it reduced exacerbations and improved quality of life. The program is adaptable for home use and other pediatric conditions.

Keywords:
BronchiectasisExacerbationExercisePediatricPhysical activityRandomized Controlled trial

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Area of Science:

  • Pediatric Respiratory Medicine
  • Exercise Physiology
  • Clinical Trials

Background:

  • Bronchiectasis (BE) unrelated to cystic fibrosis (CF) significantly impacts children's health, causing frequent exacerbations and reduced quality of life.
  • Current guidelines recommend exercise for BE management, but its benefits in pediatric populations remain unproven.
  • The BREATH trial addresses this gap by evaluating a novel therapeutic exercise program for children with BE.

Purpose of the Study:

  • To test the efficacy of an 8-week, play-based therapeutic exercise program in reducing acute exacerbations in children with BE over 12 months.
  • To assess the program's cost-effectiveness, impact on aerobic fitness, movement skills, physical activity, and quality of life.
  • To establish the health benefits of therapeutic exercise in pediatric BE.

Main Methods:

  • A multi-center, observer-blinded, randomized controlled trial (RCT) with 1:1 allocation.
  • 174 children (aged 4-12 years) with BE randomized to a play-based exercise program or usual care.
  • Assessments of exacerbations and secondary outcomes at baseline, post-intervention, 6, and 12 months, with monthly parental contact for exacerbation tracking.

Main Results:

  • The BREATH trial is the first fully powered RCT to evaluate therapeutic exercise for pediatric bronchiectasis.
  • The study will provide data on the program's impact on exacerbation frequency, fitness, movement competence, and HR-QoL.
  • Results have the potential to shift therapeutic exercise prescription in pediatric chronic respiratory conditions.

Conclusions:

  • The play-based exercise program is developmentally appropriate and tailored for children with BE.
  • The intervention is readily translatable, requiring no expensive equipment and deliverable in various settings.
  • The program shows potential for application in other pediatric groups needing exercise therapy, such as those with obesity or neurological conditions.