Kronik Obstrüktif Akciğer Hastalarında Solunum Egzersizlerinin Etkinliği

Abstract

Amaç: Bu çalışmada KOAH’lı hastalarda solunum egzersizleri ile bunlara ilave aerobik egzersizlerin solunum parametreleri, aerobik kapasitesi, yaşam kalitesine ve hastanın psikolojik durumu üzerine olan etkinliğinin araştırılması amaçlandı.

Yöntem: Altmış beş hasta pulmoner egzersiz, kombine egzersiz (pulmoner+aerobik egzersiz) ve kontrol grubu olmak üzere 3 gruba randomize edildi. Demografik veriler kaydedildi. Solunum fonksiyon testleri, maksimal inspirasyon basıncı (Pİmax), PEmax (maksimal ekspirasyon basıncı) ve Egzersiz Tolerans Testi (ETT) değerlendirildi. Medical Research Council (MRC) Dispne Skalası, modifiye Bruce ETT ve 6 dakika yürüme testi ile egzersiz kapasiteleri, vücut kitle indeksi (B), obstrüksiyon (O), dispne skalası (D), egzersiz kapasitesi (E) BODE indeksi, Kısa Form-36 (KF-36), Saint George Solunum Sorgulaması (SGRS) ile yaşam kalitesi parametreleri tedavi öncesi ve 8 haftalık tedavi sonrası kaydedildi.

Bulgular: Tedavi sonrası pulmoner egzersiz ve kombine egzersiz grubunda 1. Saniye zorlu ekspiratuvar volüm (FEV1), FEV1/zorlu vital kapasite (FVC), Pİmax, PEmax; kombine egzersiz grubunda FVC, vital kapasite (VK) değerlerinde istatistiksel olarak anlamlı artış tespit edildi (tüm parametreler için p<0,05). Her iki egzersiz grubunda MRC dispne skalası, Metabolik eşdeğer MET değerleri, SGRS ve KF-36 bazı parametrelerinde istatistiksel olarak anlamlı fark gözlendi (tüm parametreler için p<0,05). Kontrol grubunda incelenen parametrelerin hiçbirinde anlamlı gözlenmedi. Tedavi sonrası parametrelerde pulmoner ve kombine egzersiz grubu arasında fark saptanmadı (p>0,05).

Sonuç: Solunum ve kombine (solunum+ aeorobik) egzersiz uygulamalarının KOAH’lı hastalarda egzersiz kapasitesi, dispne ve yaşam kalitesini anlamlı şekilde artırdığı saptanmıştır.

Keywords

• Pulmoner rehabilitasyon,Egzersiz,Dispne,Kronik Obstrüktif Akciğer Hastalığı

Efficacy of Pulmonary Exercises in Chronic Obstructive Pulmonary Disease

Abstract

Objective: The aim of this study was to determine the effectiveness of pulmonary rehabilitation on respiratory parameters, aerobic exercise capacity, quality of life and psychological status of the patients with chronic obstructive pulmonary disease (COPD). The addition of aerobic exercise on pulmonary exercises was also evaluated to provide further improvements on these parameters.

Methods: Sixty-five patients were randomly assigned to carry out pulmonary exercise, combined (respiratory plus aerobics) and, a control groups. Demographic characteristics were noted. Respiratory function tests, maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) values and, exercise tolerance test (ETT) were assessed. Medical Research Council (MRC) dyspnea scale, body mass index (B), airway obstruction (O), dyspnea scale (D), exersice capacity (E) (BODE)  index, Short Form 36 (SF-36), and Saint George Respiratory Questionnaire (SGRQ) obtained from each patient were recorded before the treatment, and after the 8-week treatment.

Results: After the treatment significant increases were found in forced expiratory volume-one second (FEV1),  FEV1/forced vital capacity (FVC) ratio, PImax, PEmax values in pulmonary and combined exercise groups, and FVC, vital capacity (VC) values in combined exercise group (p<0.05 for all parameters). Statistical differences were observed in both exercise groups regarding MRC Dyspnea score, Maksimum Equivalent Task (MET)  values, SGRQ and some parameters of SF-36 (p<0.05 for all parameters). In the control group no noticeable difference was observed in any of the parameters. After treatment there was no difference between pulmonary and combined exercise group in any parameters (p<0.05).

Conclusion: Both pulmonary and combined exercise programs improved exercise capacity, dyspnea, and the life quality of the COPD patients. 

Keywords

• Pulmonary rehabilitation,Exercise,Dyspnea,Chronic Obstructive Pulmonary Disease

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