Ankilozan Spondilitli Bireylerde Hangi Solunum Eğitimi Daha Etkilidir: 360-Derece Ekspanse Diyafram Egzersizleri mi, Standart Diyafram Egzersizleri mi? Randomize Kontrollü Çalışma

Abstract

Amaç: Solunum komplikasyonları genellikle asemptomatik olsa da Ankilozan Spondilit (AS) hastalarında önemli bir morbidite ve mortalite nedenidir. Egzersizin AS yönetimindeki kanıtlanmış faydalarına rağmen, geleneksel diyafram nefesi ile göğüs kafesinin tamamını hedefleyen çok boyutlu, yenilikçi yaklaşımların karşılaştırıldığı sınırlı sayıda çalışma bulunmaktadır. Bu çalışma, standart diyafram nefesi ile sensör destekli 360 derece ekspanse diyafram nefesi egzersizlerinin solunum fonksiyonu, hastalık aktivitesi ve fiziksel kapasite üzerindeki etkilerini değerlendirerek bu boşluğu doldurmayı amaçlamıştır. Gereç ve Yöntem: AS tanısı almış 50 birey, standart diyafram nefesi grubu (DG) veya 360 derece ekspanse diyafram nefesi grubu (360DG) olmak üzere rastgele iki gruba ayrılmıştır. Her iki gruba da altı hafta boyunca haftada iki kez denetimli egzersiz uygulanmıştır. Değerlendirilen sonuçlar arasında solunum fonksiyon testleri, maksimal inspiratuvar ve ekspiratuvar basınçlar (MIP/MEP) ve AS’ye özgü indeksler yer almıştır. Bulgular: Her iki grupta da işlevsel indeksler ve solunum parametrelerinde anlamlı iyileşmeler gözlemlenmiş, ancak gruplar arası farklar istatistiksel olarak anlamlı bulunmamıştır (p>0,05). Özellikle, DG grubunda FEV1/FVC oranında anlamlı bir artış (p = 0,017), 360DG grubunda ise FVC değerinde anlamlı bir artış (p = 0,007) saptanmıştır. Solunum kas gücü (MIP ve MEP) her iki grupta da anlamlı şekilde artmıştır (p<0,05). Sonuç: Bu randomize kontrollü çalışma, AS’de 360 derece ekspanse diyafram nefesi egzersizlerini değerlendiren ilk çalışmalardan biridir. Bulgular hem standart hem de sensör destekli nefes egzersizlerinin solunum ve fonksiyonel sonuçları iyileştirmede güvenli ve etkili olduğunu göstermektedir. Bu sonuçlar, fizyoterapistler ve klinisyenler için kişiye özel solunum eğitiminin AS rehabilitasyon programlarına entegre edilmesinin klinik önemini vurgulamakta ve hasta bakımını geliştirmek için esnek, kanıta dayalı stratejiler sunmaktadır. Anahtar Kelimeler: Fonksiyonel kapasite, mobilite, romatizmal hastalık, solunum.

Keywords

• fonksiyonel kapasite
• mobilite
• romatizmal hastalık
• solunum

Which Respiratory Training is More Effective in Individuals with Ankylosing Spondylitis: 360-Degree Expansion Diaphragm Exercises or Standard Diaphragm Exercises? Randomized Controlled Trial

Abstract

Objective: Respiratory complications, though often asymptomatic, are a significant cause of morbidity and mortality in individuals with Ankylosing Spondylitis (AS). Despite the proven benefits of exercise in managing AS, limited evidence exists comparing conventional diaphragmatic breathing to novel, multidimensional approaches targeting full thoracic expansion. This study aimed to address this gap by evaluating the effectiveness of standard versus 360-degree expansion diaphragm breathing exercises delivered with sensor-based feedback in improving respiratory function, disease activity, and physical capacity in AS. Material and Methods: Fifty individuals diagnosed with AS were randomized to either a standard diaphragm breathing group (DG) or a 360-degree expansion diaphragm group (360DG). Both groups received supervised exercise interventions twice weekly for six weeks. Outcomes included pulmonary function tests, maximal inspiratory and expiratory pressures (MIP/MEP), and AS-specific indices. Results: Both groups demonstrated significant improvements in functional indices and respiratory parameters, with no statistically significant intergroup differences (p>0.05). Notably, FEV1/FVC improved in the DG group (p=0.017), while FVC showed a significant increase in the 360DG group (p=0.007). Respiratory muscle strength (MIP and MEP) improved significantly in both groups (p<0.05). Conclusion: This randomized controlled trial is among the first to evaluate 360-degree expansive diaphragm breathing in AS. The findings suggest that both standard and sensor-guided breathing exercises are safe and effective in improving respiratory and functional outcomes. These results underscore the clinical relevance of incorporating tailored respiratory training into rehabilitation programs for AS, offering physiotherapists and clinicians flexible, evidence-based strategies to improve patient care. Keywords: Functional capacity, mobility, respiration, rheumatic disease

Keywords

• Functional capacity
• mobility
• respiration
• rheumatic disease

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