Physical activity levels and influencing factors in individuals with bronchiectasis: a cross-sectional study

Bronchiectasis is a chronic respiratory condition characterized by irreversible bronchial dilatation, persistent airway inflammation, and impaired mucociliary clearance. Physical activity (PA) plays a key role in improving respiratory health and quality of life, yet objective data on PA levels and their clinical determinants in bronchiectasis are limited. We aimed to assess PA levels using wrist-worn accelerometry in individuals with non-cystic fibrosis (non-CF) bronchiectasis and to explore their association with clinical, functional, and inflammatory parameters. This cross-sectional study enrolled 27 adults with stable non-CF bronchiectasis (median age: 68.5 years; 40.7% female). Participants wore an AX3 wrist accelerometer for 7 consecutive days and were categorized into light or moderate/vigorous activity groups based on the World Health Organization guidelines. Clinical characteristics, pulmonary function (including airway resistance), and inflammatory markers [eosinophil count, fractional exhaled nitric oxide (FeNO)] were collected and analyzed. Logistic regression models were used to explore associations between these variables and PA levels. Patients with higher PA levels demonstrated lower airway resistance and reduced markers of type 2 inflammation. In univariate analysis, airway resistance, eosinophil count, FeNO, and age were significantly associated with PA levels. However, none of these factors retained significance in the multivariate model. Thus, reduced PA in bronchiectasis appears to be influenced by both airway inflammation and physiological factors such as aging. Inflammatory burden and impaired airway mechanics may limit functional capacity, underscoring the need for comprehensive management strategies that address both inflammation and mobility to improve patient outcomes.