BREATH STUDY: Short and long-term effects of therapeutic exercise in children with bronchiectasis: a multi-centre randomised controlled trial

A tailored therapeutic exercise programme delivered by trained exercise therapists. The program focuses on developing and enhancing children’s confidence, motivation, functional motor skills (FMS) proficiency, and aerobic fitness through the use of developmentally-appropriate, play-based activity stations designed specifically to suit individual needs. It is comprised of a combination of supervised and unsupervised exercise therapy sessions. Therapists and parents will be required to follow a detailed program manual and standard operating procedures. Sessions will be conducted in local community centres or at the Centre for Children's Health Research South Brisbane. The supervised component consists of 60-minute group sessions, completed on a weekly basis for 8 weeks, led by a clinical exercise physiologist or physiotherapist. During the supervised group sessions, children rotate through at least 6 activity stations where they complete developmentally appropriate games targeting specific FMS’s. The activity stations are sequenced so that a high intensity game is always followed by a low intensity game, thus ensuring that aerobic fitness is promoted in a safe and effective manner. Activities are tailored to the child’s fitness and skill level by modifying the intensity and duration of each session, and/or modifying the equipment. There will be up to six children each session. Children will participate in a warm up followed by a circuit of different activities and games targeting functional movement skills and cardiovascular fitness. There will be a group activity at the half way point and the session will end with a cool down. Children spend six minutes at each activity; 30s to switch stations, 30s to orientate to game, 5 minutes to complete activity (chosen from the FMS Activity Catalogue) before moving to the next activity. Each activity is designed to be tailored to the child’s individual fitness and skill level One group activity is incorporated per session to target social connection, work as a team and integrate into a bigger group. The group activity will be a modified game from the FMS Activity Catalogue. The group activity is 10 minutes long Heart rate will be monitored during the session using an upper arm monitor. Data collection will include a subjective rates from the instructor on the effectiveness of the game. Example outline of an 8-week program - Weeks 1-8 Warm up- 6 min FMS Activity - Kicking 6 min Strength 6 min Hit, strike, dribble 6 min Group Activity/Game 10 min FMS Activity Throwing & Catching 6 min Balance 6 min Agility & coordination 6 min Cool down 2 min The unsupervised component consists of a home-based, parent-led exercise program, completed 2 days per week (~ 20 minutes per session) for 8 weeks (the same 8 weeks in which the supervised session is taking place), during which children and parents complete 2 games or activity stations from their most recent 60-minute supervised group session. Examples of games targeting a range of FMS’s and fitness parameters, including kicking, underarm striking, throwing and catching, locomotion, strength, and balance. All sessions begin with a 5-minute warm up and end with a 5-minute cool down consisting of stretching and relaxation exercises. Exercise intensity during each program session is monitored continuously with a heart rate monitor. Fidelity is measure via parent report and parent records of heart rate and activities conducted at each session.