Nonpharmacologic Care of Bronchiectasis: Addressing Frailty with Nutrition and Physical Activity.

IF 3.4 Q2 RESPIRATORY SYSTEM

Pulmonary Therapy Pub Date : 2026-03-01 Epub Date: 2025-10-30 DOI:10.1007/s41030-025-00328-9

Chetana Pendkar, Amarpreet K Ahluwalia

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引用次数: 0

Abstract

Introduction: Bronchiectasis is a chronic airway disease marked by recurrent infections, progressive inflammation, and declining pulmonary function. While pharmacologic therapies remain central to management, nonpharmacologic strategies-particularly nutrition and physical activity-are underutilized, despite growing evidence.

Objective: This review examines the role of nutritional support and physical activity in managing bronchiectasis, highlighting their impact on frailty, systemic inflammation, and functional outcomes.

Discussion: Frailty is increasingly recognized in bronchiectasis, particularly in patients with comorbid nontuberculous mycobacterial lung disease (NTM-LD), where prevalence may exceed 40%. Malnutrition, low body mass index (BMI), and sarcopenia are associated with poorer lung function, increased hospitalizations, and mortality. Meanwhile, physical inactivity-measured by low step count and prolonged sedentary time-is a strong predictor of exacerbation risk and healthcare utilization. Evidence supports the use of high-calorie, protein-rich diets and resistance-based exercise training to improve muscle mass, immune function, and quality of life. Synergistic effects are observed when nutritional interventions are combined with pulmonary rehabilitation. However, barriers to implementation remain, including a lack of access, under-referral, and limited emphasis on guidelines.

Conclusion: Nutritional and physical activity interventions offer measurable clinical benefits in bronchiectasis and should be integrated into routine multidisciplinary care. Future research should prioritize the validation of frailty screening tools, the implementation of effective strategies, and the development of policy mechanisms to expand coverage for dietetic and rehabilitation services.

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支气管扩张的非药物治疗：通过营养和身体活动解决虚弱问题。

简介：支气管扩张是一种慢性气道疾病，以反复感染、进行性炎症和肺功能下降为特征。尽管越来越多的证据表明，药物治疗仍然是治疗的核心，但非药物策略，特别是营养和体育活动，尚未得到充分利用。目的：本综述探讨了营养支持和身体活动在支气管扩张管理中的作用，强调了它们对虚弱、全身性炎症和功能结局的影响。讨论：虚弱越来越多地在支气管扩张中被认识到，特别是在合并非结核性分枝杆菌肺病（NTM-LD）的患者中，患病率可能超过40%。营养不良、低体重指数（BMI）和肌肉减少症与肺功能差、住院率和死亡率增加有关。同时，身体不活动——通过低步数和长时间久坐来衡量——是病情恶化风险和医疗保健利用的有力预测指标。有证据支持使用高热量、富含蛋白质的饮食和基于阻力的运动训练来改善肌肉质量、免疫功能和生活质量。当营养干预与肺康复相结合时，可以观察到协同效应。然而，实施的障碍仍然存在，包括缺乏机会、转诊不足和对指导方针的重视有限。结论：营养和体育活动干预对支气管扩张有显著的临床疗效，应纳入常规多学科治疗。未来的研究应优先考虑虚弱筛查工具的验证，有效策略的实施，以及扩大饮食和康复服务覆盖面的政策机制的发展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pulmonary Therapy Medicine-Pulmonary and Respiratory Medicine

CiteScore

5.20

自引率

3.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Pulmonary Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the use of pulmonary therapies, devices, and surgical techniques. Areas of focus include, but are not limited to: asthma; chronic obstructive pulmonary disease; idiopathic pulmonary fibrosis; pulmonary hypertension; cystic fibrosis; lung cancer; respiratory tract disorders; allergic rhinitis and other respiratory allergies; influenza, pneumococcal infection, respiratory syncytial virus and other respiratory infections; and inhalers and other device therapies. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Pulmonary Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of pulmonary therapies. Open Access All articles published by Pulmonary Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. Digital Features and Plain Language Summaries Pulmonary Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €4500/ $5100/ £3650. The journal will consider fee discounts and waivers for developing countries and this is decided on a case by case basis. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials, and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors’ or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Authors should disclose details of preprint posting during the submission process or at any other point during consideration in one of our journals. Once the manuscript is published, it is the author’s responsibility to ensure that the preprint record is updated with a publication reference, including the DOI and a URL link to the published version of the article on the journal website. Please follow the link for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Copyright Pulmonary Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0. Contact For more information about the journal, including pre-submission enquiries, please contact christopher.vautrinot@springer.com.