Pulmonary Rehabilitation Approaches in Patients with Spinal Cord Injury

Öz

Abstract
Pulmonary complications after spinal cord injury are the main cause of morbidity and mortality in the acute period. In this period, more than half of patients develop life threatening respiratory problems such as atelectasis, pneumonia and respiratory failure. The degree of respiratory dysfunction depends on the extent and level of neurological damage, and individuals with high cervical and thoracic lesions are known to have a higher risk. Patients should be comprehensively evaluated for respiratory symptoms. Commonly used techniques to reduce secretions and increase ventilation include postural drainage, percussion, vibration, diaphragmatic breathing, segmental breathing, cough techniques, and aspiration. With the pulmonary rehabilitation approaches applied, it is observed that quality of life improves with the increase in their participation in daily life with the recovery of patients from mechanical ventilation, removal of secretions, strengthening of respiratory muscles, development of cough capacity and increasing ventilation.

Keywords: Spinal cord injury, spirometer, breathing exercises, rehabilitation.

Anahtar Kelimeler

• spinal cord injury
• spirometer
• breathing exercises

Spinal Kord Yaralanmalı Hastalarda Pulmoner Rehabilitasyon Yaklaşımları

Öz

Özet

Spinal kord yaralanması sonrası, pulmoner komplikasyonlar, akut dönemde morbidite ve mortalitenin ana sebebidir. Bu dönemde hastaların yarıdan fazlasında atelektazi, pnömoni ve solunum yetmezliği gibi yaşamı tehdit eden solunumla ilişkili sorunlar gelişmektedir. Solunum fonksiyon bozukluğunun derecesi, nörolojik hasarın kapsamı ve seviyesine bağlı olup, yüksek servikal ve torasik lezyonu olan bireylerin daha yüksek risk taşıdığı bilinmektedir. Hastalar solunum semptomları açısından kapsamlı olarak değerlendirilmelidir. Hastalarda sekresyonları azaltmak ve dışarıya atılımını sağlamak, ventilasyonu artırmak için yaygın olarak kullanılan teknikler, postüral drenaj, perküsyon, vibrasyon, diyafragmatik solunum, segmental solunum, öksürük teknikleri ve aspirasyon gibi yaklaşımları içermektedir. Uygulanan pulmoner rehabilitasyon yaklaşımları ile hastaların mekanik ventilasyondan kurtarılması, sekresyonların atılması, solunum kaslarının kuvvetlendrilmesi, öksürüğün geliştirilmesi ve ventilasyonun artırılmasıyla birlikte günlük yaşama katılımlarında artışla birlikte yaşam kalitelerinin geliştiği görülmektedir.

Anahtar Kelimeler: Spinal kord yaralanması, spirometre, solunum egzersizleri, rehabilitasyon.

Anahtar Kelimeler

• spinal kord yaralanması
• spirometre
• solunum egzersizleri
• rehabilitasyon

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