Pulmoner rehabilitasyonun COVID-19 Hastalarında Ağrı, Solunum Fonksiyonları ve Günlük Yaşam Aktivitelerine Etkisi

Öz

Giriş: Koronavirüs hastalığı 2019 (COVID-19), çoklu sistem tutulumu nedeniyle multidisipliner bir yaklaşım gerektirir. COVID-19 hastalarında pulmoner rehabilitasyon gerekebilir. Çalışmamızda şiddetli akciğer tutulumu, nefes darlığı olan hastalarda sırt ağrısı sonrası uygulanan pulmoner rehabilitasyon programının etkisini ve hastaların sağlık profillerini incelemeyi amaçladık. Yöntem: Retrospektif olarak planlanan çalışmamıza, ileri akciğer tutulumu tanısı ile COVID-19 tedavisi gören, hastaneden taburcu edilen ve göğüs hastalıkları polikliniği 1.ay kontrollerinde nefes darlığı, sırt ağrısı ve günlük yaşam aktivitelerinde güçlük saptanması sonrası 1 ay süre ile pulmoner rehabilitasyon programına alınan 50 hasta dahil edildi. Pulmoner rehabilitasyon programı öncesi ve 1 ay sonrasında sırt ağrısı Vizüel Analog Skala (VAS) ile, dispne düzeyi Modifiye Tıbbi Araştırma Konseyi Skalası (mMRC) ile ve sağlık profili Notthingham skalası ile değerlendirilmişti. Bulgular: Pulmoner rehabilitasyon programının başlangıcı ile bitişi arasında mMRC Skalası puanları (p<0.001) ve sırt ağrısı VAS puanları (p<0.001) arasında istatistiksel olarak anlamlı fark bulundu (p<0.001). Ayrıca pulmoner rehabilitasyon programı sonrası “Nottingham Sağlık Profili” puanlarında tüm alt gruplarda (NHP “ağrı”: p<0,001, NHP “duygusal reaksiyonlar”: p<0,001, NHP “uyku” :p<0.001, NHP “sosyal izolasyon”: p<0.001, NHP “fiziksel aktivite”: p<0.001, NHP “enerji düzeyi”: p<0.001) başlangıç puanlarına göre anlamlı iyileşme tespit edildi Tartışma ve Sonuç: Post COVİD sendrom erken tanı takip açısından önemlidir. Bu çalışmada şiddetli akciğer tutulumu olan COVID-19'un akut döneminden sonra uygulanan pulmoner rehabilitasyon programının sırt ağrısı, nefes darlığı semptomları ve sağlık profilini iyileştirdiği görülmüştür. Bu konuda yapılmış randomize kontrollü yeni çalışmalara ihtiyaç olduğunu düşünmekteyiz.

Anahtar Kelimeler

• COVID-19
• Pulmoner rehabilitasyon
• Sağlık Profili

The Effect of Pulmonary Rehabilitation on Pain, Respiratory Functions and Activities of Daily Living in COVID-19 Patients

Öz

Abstract Introduction: Coronavirus disease 2019 (COVID-19) requires a multidisciplinary approach owing to its multisystem involvement. Pulmonary rehabilitation may be required in patients with COVID-19. In our study, we aimed to examine the effect of the pulmonary rehabilitation program applied after the acute period of back pain in patients with severe pulmonary involvement, dyspnea and health profiles of the patients. Method: In our retrospectively planned study, 50 patients with advanced pulmonary involvement who were treated for COVID-19 and discharged from the hospital and who were diagnosed with shortness of breath, back pain and difficulties in daily living activities in the 1st month chest diseases polyclinic controls and who were given a pulmonary rehabilitation program for a period of 1 month were included in our study. Before and 1 month after the pulmonary rehabilitation program, back pain was evaluated with the VAS, respiratory functions were evaluated with the Modified Medical Research Council Scale, and activities of daily living were evaluated with the Notthingham scale. Results: A statistically significant difference was found between the beginning and the end of the pulmonary rehabilitation program in the Modified Medical Research Council Scale scores (p<0.001) and back pain VAS scores (p<0.001) was detected. Moreover, it was obtained significant improvement at baseline scores of “The Nottingham Health Profile” scores after the pulmonary rehabilitation program in all subgroups (NHP “pain”: p<0.001, NHP “emotional reactions”: p<0.001, NHP “sleep”: p<0.001, NHP “social isolation”: p<0.001, NHP “physical activity”: p<0.001, NHP “energy level”: p<0.001). Conclusion: Post-COVID syndrome treatment and follow-up are important for early prevention. The pulmonary rehabilitation program applied after the acute period of with severe lung involvement COVID-19 has been seen to improve back pain, dyspnea symptoms and health profile. There is a need for new randomized controlled studies on this subject.

Anahtar Kelimeler

• COVID-19
• Health Profile
• Pulmonary Rehabilitation

Kaynakça

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