Kronik Obstrüktif Akciğer Hastalığında Üst Ekstremite Fonksiyonel Değerlendirmesi: Bir Derleme Makalesi

Abstract

Kronik obstrüktif akciğer hastalığı (KOAH), genellikle zararlı partiküllere veya gazlara ciddi bir şekilde maruz kalmanın neden olduğu hava yolu inflamasyonu ve alveolar anormalliklere bağlı kalıcı solunum semptomları ve hava akımı kısıtlanması ile karakterize, yaygın, önlenebilir ve tedavi edilebilir bir hastalıktır. Genellikle bu hastalıkla beraber karşılaşılan semptomlar dispne, öksürük ve balgamdır. KOAH, esas olarak bir solunum sistemi hastalığı olmasına rağmen, bozulmuş solunum fonksiyonu, KOAH'lı bireylerin yaşadığı problemlerden sadece bir tanesidir. Ekspiratuar hava akımı sınırlaması ve dispneye ek olarak, KOAH'lı hastalarda sıklıkla kardiyovasküler hastalıklar, osteoporoz, ekstremite kas disfonksiyonu ve psikolojik bozukluklar gibi komorbiditeler mevcuttur. Bunların tümü fonksiyonel kapasitenin azalmasına ve günlük yaşam aktivitelerine kısıtlı katılıma katkıda bulunur. Fonksiyonel değerlendirme içerik olarak; ayakta durma, temel vücut pozisyonunu değiştirme, yürüme, ayakta durma, nesneleri tutma ve taşıma gibi üst ve alt ekstremite aktivitelerine odaklanır. Literatüre bakıldığında KOAH’lı hastalarda üst ekstremite fonksiyonel değerlendirmelerine yönelik sınırlı sayıda çalışma mevcuttur. Bu nedenle bu derlemenin amacı, KOAH’lı hastalarda üst ekstremite fonksiyonel değerlendirmesi için kullanılan yöntemlerle ilgili bilgileri sunmaktır.

Keywords

• Kronik obstrüktif akciğer hastalığı
• üst ekstremite
• değerlendirme
• fiziksel fonksiyonel performans

Upper Extremity Functional Evaluation in Chronic Obstructive Pulmonary Disease: A Review Article

Abstract

Chronic obstructive pulmonary disease (COPD) is a common, preventable and treatable that is characterized by persistent respiratory symptoms and airflow inflammation that is due to airway and alveolar abnormalities usually caused by significant exposure to noxious particles or gases. The symptoms usually associated with this disease are dyspnea, cough and sputum. Despite the fact that chronic obstructive pulmonary disease is primarily a respiratory disease, impaired respiratory function is only one aspect of the disability experienced by individuals with chronic obstructive pulmonary disease. In addition to expiratory flow limitation and dyspnea, patients with chronic obstructive pulmonary disease often have comorbidities such as cardiovascular diseases, osteoporosis, limb muscle dysfunction, and psychological disorders. All of these contribute to the limitation of functional capacity and limited participation in activities of daily living. Functional assessment should focus on upper extremity physical functional activities such as standing, changing basic body position, walking, standing, holding and carrying objects. In the literature, there are limited studies on upper extremity functional evaluations in patients with chronic obstructive pulmonary disease. Therefore, the purpose of this review is to present information about the methods used for upper extremity functional assessment in patients with chronic obstructive pulmonary disease.

Keywords

• Chronic obstructive pulmonary disease
• upper extremity
• assessment
• physical functional performance

References

1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2021 Report). GOLD. https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf. Erişim tarihi 23 Haziran 2021.
2. Schönhofer B, Ardes P, Geibel M, Köhler D, Jones PW. Evaluation of a movement detector to measure daily activity in patients with chronic lung disease. Eur Respir J. 1997;10:2814–2819. doi:10.1183/09031936.97.10122814.
3. Pitta F, Troosters T, Spruit MA, Probst VS, Decramer M. Gosselink R. Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005;171:972–977. doi:10.1164/rccm.200407-855OC.
4. GOLD. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). GOLD. https://www.farm.ucl.ac.be/Benin/2014/pharmacologie-speciale/6-systeme respiratoire/GOLD_Pocket2014_Jan30.pdf. Yayınlanma tarihi 2014. Erişim tarihi 23 Haziran 2021.
5. Annegarn J, Meijer K, Passos VL, et al. Rehabilitation network. Problematic activities of daily life are weakly associated with clinical characteristics in COPD. J Am Med Dir Assoc. 2012;13:284–290. doi:10.1016/j.jamda.2011.01.002.
6. Bui KL, Nyberg A, Maltais F, Saey D. Functional tests in chronic obstructive pulmonary disease, part 1: clinical relevance and links to the international classification of functioning, disability, and health. Ann Am Thorac Soc. 2017;14(5):778–784. doi:10.1513/annalsats.201609-733as.
7. World Health Organization. International Classification of Functioning, Disability and Health. Geneva: World Health Organization. http://apps.who.int/iris/bitstream/handle/10665/42407/9241545429.pdf;jsessionid=8674B60F5AE851EED27DF3DB13C0B633?sequence=1. Yayınlanma tarihi 2001. Erişim tarihi 1 Temmuz 2021.
8. World Health Organization. Towards a common language for functioning, disability and health ICF. International Classification. http://www.who.int/classifications/icf/training/icfbeginnersguide.pdf. Yayınlanma tarihi 2002. Erişim tarihi 1 Temmuz 2021.

9. Stier-Jarmer M, Grill E, Müller M, Strobl R, Quittan M, Stucki G. Validation of the comprehensive ICF Core Set for patients in geriatric post-acute rehabilitation facilities. J Rehabil Med. 2011;43:102–112. doi:10.2340/16501977-0617.
10. Jácome C, Marques A, Gabriel R, Figueiredo D. Chronic obstructive pulmonary disease and functioning: implications for rehabilitation based on the ICF framework. Disabil Rehabil. 2013;35:1534–1545. doi:10.3109/09638288.2012.745625.
11. Bui KL, Nyberg A, Maltais F, Saey D. Functional tests in chronic obstructive pulmonary disease, Part 2: Measurement Properties. Ann Am Thorac Soc. 2017;14(5):785-794. doi: 10.1513/AnnalsATS.201609-734AS.
12. Vaes AW, Wouters EFM, Franssen FME, et al. Task related oxygen uptake during domestic activities of daily life in patients with COPD and healthy elderly subjects. Chest. 2011;140:970–979. doi:10.1378/chest.10-3005.
13. Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994;84:351–358. doi:10.2105/ajph.84.3.351.
14. Lima VP, Iamonti VC, Velloso M, Janaudis-Ferreira T. Physiological responses to arm activity in individuals with chronic obstructive pulmonary disease compared with healthy controls: a systematic review. J Cardiopulm Rehabil Prev. 2016;36:402–412. doi: 10.1097/HCR.0000000000000190.
15. Takahashi T, Jenkins SC, Strauss GR, Watson CP, Lake FR. A new unsupported upper limb exercise test for patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2003;23(6):430-7. doi:10.1097/00008483-200311000-00007.
16. Hill CJ, Denehy L, Holland AE, McDonald CF. Measurement of functional activity in chronic obstructive pulmonary disease: the grocery shelving task. J Cardiopulm Rehabil Prev. 2008;28(6):402-9. doi:10.1097/HCR.0b013e31818c3c65.
17. Zhan S, Cerny FJ, Gibbons WJ, Mador MJ, Wu YW. Development of an unsupported arm exercise test in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2006;26(3):180-7;188-90. doi: 10.1097/00008483-200605000-00013.
18. Celli BR, Rassulo J, Make BJ. Dyssynchronous breathing during arm but not leg exercise in patients with chronic airflow obstruction. N Engl J Med. 1986;314(23):1485–1490. doi:10.1056/NEJM198606053142305.
19. Nyberg A, Lindström B, Wadell K. Assessing the effect of high-repetitive single limb exercises (HRSLE) on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD): study protocol for randomized controlled trial. Trials. 2012;13:114. doi:10.1186/1745-6215-13-114.
20. Reis IM, Basso-Vanelli R, Beltrame T, et al. Acute effects of the 6-Minute Pegboard and Ring Test in COPD. Respiratory Care.2020;65(2):198-209. doi:https://doi.org/10.4187/respcare.06948.
21. Barros C, Felisberto R, Nucci K, et al. Dynamic hyperinflation induced by the 6- minute pegboard and ring test in hospitalized patients with exacerbated COPD. PLoS One. 2020;15(11):e0241639. doi: 10.1371/journal.pone.0241639.
22. Felisberto R, Barros C, Nucci K, et al. Is the 6-minute pegboard and ring test valid to evaluate upper limb function in hospitalized patients with acute exacerbation of COPD? International Journal of Chronic Obstructive Pulmonary Disease. 2018;13:1663–1673. doi:10.2147/copd.s161463.
23. Janaudis Ferreira T, Hill K, Goldstein RS, Wadell K, Brooks D. Relationship and responsiveness of three upper-limb tests in patients with chronic obstructive pulmonary disease. Physiother Can. 2013;65:40–43. doi:10.3138/ptc.2011-49.
24. Nyberg A, Törnberg A, Wadell K. Correlation between limb muscle endurance, strength, and functional capacity in people with chronic obstructive pulmonary disease. Physiother Can. 2016;68:46–53. doi:10.3138/ptc.2014-93.
25. Janaudis Ferreira T, Beauchamp MK, Goldstein RS, Brooks D. How should we measure arm exercise capacity in patients with COPD? a systematic review. Chest. 2012;141:111–120. doi:10.1378/chest.11-0475.