Palyatif Bakımda Egzersiz ve Fizyoterapi Uygulamaları

Yıl 2021, Cilt: 3 Sayı: 2, 97 - 102, 04.07.2021

Muammer Çorum

Öz

Palyatif bakım Dünya Sağlık Örgütü’nün (WHO) tanımına göre özellikle kanser hastalarında veya yaşamı tehdit eden herhangi bir hastalığın terminal döneminde, hastanın ve ailesinin (bakım verenin) kapsamlı bir değerlendirme ile yaşadığı sorunları azaltmaya ve yaşam kalitesini artırmaya odaklanan fiziksel, psikososyal ve ruhsal ihtiyaçların karşılanmasına yönelik uygulamaların yer aldığı bir yaklaşımdır. Palyatif bakım sürecinde fizyoterapi ve rehabilitasyon uygulamaları önceden ihmal edilirken son yıllarda yapılan çalışmalarla semptomların azaltılması ve hastaların yaşam kalitesinin artmasında önemli bir etkiye sahip olduğu anlaşılmıştır. Özellikle mobiliteyi artırmaya teşvik etme, egzersiz yapmalarını sağlama ve günlük yaşama adapte edilen hareket önerilerinin hastaların yaşam kalitelerini ve iyilik halini artıran yaklaşımlar olduğunu gösteren kanıtlar mevcuttur. Bu çalışmanın amacı literatür taranarak mevcut kanıtlarla Palyatif bakım dönemindeki hastalara yönelik egzersiz ve fizyoterapi uygulamalarının etkilerini incelemektir.

Anahtar Kelimeler

Egzersiz, Fizyoterapi, Palyatif Bakım, Rehabilitasyon

Exercise And Physiotherapy Applications In Palliative Care

Öz

Palliative Care According to the definition of the World Health Organization (WHO), the physical, psychosocial and spiritual needs focusing on reducing the problems experienced by the patient and his family (caregiver) and increasing the quality of life, with a comprehensive evaluation, especially in cancer patients or in the terminal phase of any life-threatening disease. It is an approach that includes practices aimed at meeting. While physiotherapy and rehabilitation applications were previously neglected during the Palliative Care process, it has been understood that studies conducted in recent years have an important effect on reducing symptoms and increasing the quality of life of patients. In particular, there is evidence that encouraging mobility, enabling them to exercise, and suggestions of action adapted to daily life are approaches that improve the quality of life and well-being of patients. The aim of this study is to examine the effects of exercise and physiotherapy applications on patients in the Palliative Care period with the available evidence by scanning the literature.

Anahtar Kelimeler

Exercise, Palliative care, Physiotherapy, Rehabilitation

Kaynakça

• 1) Kabalak AA, Öztürk H, Çağıl H, Yaşam Sonu Bakım Organizasyonu; Palyatif Bakım. Yoğun Bakım Dergisi 2013;11(2):56-70.
• 2) World Health organization WHO definition of palliative care 2013. https://www.who.int/cancer/palliative/definition/en/ (Erişim Tarihi:25.09.2020)
• 3) Lorenz KA, Lynn J, Dy SM, Shugarman LR, Wilkinson A, Mularski RA, et al. Evidence for improving palliative care at the end of life: a systematic review. Ann Intern Med 2008;148:147-59.
• 4) Sepúlveda C, Marlin A, Yoshida T, Ullrich A. Palliative care: the World Health Organization's global perspective. J Pain Symptom Manage 2002;24:91-6.
• 5) Yürüyen M, Özbaş Tevetoğlu I, Tekmen Y, Polat Ö, Arslan İ, Okuturlar Y. Prognostic factors and clinical features in palliative care patients. Konuralp Medical J 2018;10:74–80.
• 6) Borasio GD. Translating the World Health Organization definition of palliative care into scientific practice. Palliat Support Care 2011;9:1-2.
• 7) Santigo-Palma J.,Payne R: Palliative Care and Rehabilitation.: Cancer Supplement; 92, 4;1049-1052, 2011.
• 8) Nyatanga B, Physical exercise for those living with and beyond cancer: Changing perceptions in palliative caring, British Journal of Community Nursing, 2017; 22(6).
• 9) Vargo MV, Gerber LH: Kanser Tanılı Hastalarda Rehabilitasyon, Delisa JA(editör). Fiziksel Tıp ve Rehabilitasyon İlkeler ve Uygulamalar, Cilt 2, Ankara, Güneş Tıp Kitabevi, 2007, s.1773-1794.
• 10) Strada E.A, Portenoy RK, Abraham J, Savarese D: Psychological, rehabilitative, and integrative therapies for cancer pain, 2018: https://www.uptodate. com/contents/psychological-rehabilitative-andintegrative-therapies-for-cancer-pain (Erişim tarihi: 26. 09. 2020).
• 11) Jensen W, Baumann FT, Stein A, et al. Exercise training in patients with advanced gastrointestinal cancer under going palliative chemotherapy: a pilot study; Suppor tCare Cancer 2014;22: 1797-1806.
• 12) Eyigor S, Yesil H, Necessıty Of Pallıatıve Care In The Intensıve Care. Kocatepe Medical Journal 2017;18:78-84.
• 13) Bourdin G, Barbier J, Burle JF, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55:400-7
• 14) Hanekom S, Gosselink R, Dean E, et al. The development of a clinical management algorithm for early physical activity and mobilization of critically ill patients: synthesis of evidence and expert opinion and its translation into practice. Clin Rehabil. 2011;25:771-87
• 15) Pohlman MC, Schweickert WD, Pohlman AS, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38:2089-94.
• 16) Gosselink R, Needham D, Hermans G. ICU-based rehabilitation and its appropriate metrics. Curr Opin Crit Care. 2012;18:533-9.
• 17) Sommers J, Engelbert RH, Dettling- Ihnenfeldt D, Gosselink R et al. Physiotherapy in the intensive care unit: an evidence- based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil 2015; 29(11):1051-63
• 18) De Rezende LFM, López JP, Rodrigues VK, Matsudo M, Luiz OC, Sedentary behavior and health outcomes among older adults: a systematic review. BMC Public Health 2014;14: 333
• 19) Thomas RJ, Holm M, Al-Adhami A, Physical activity after cancer: An evidence review of the international literature. BJMP 2014;7(1): a708
• 20) Fong DYT, Ho JWT, Hui BPH, Physical activity for cancer survivors: meta-analysis of randomised Controlled Trials. Br Med J 2012;344: e70
• 21) G. Sheill, E. Guinan, L. O. Neill, D. Hevey, J. Hussey, Physical activity and advanced cancer: the views of oncology and palliative care physicians in Ireland. Ir J Med Sci. 2018;187:337–342. DOI 10.1007/s11845-017-1677-x.
• 22) Adamsen L, Stage M, Laursen J, Rorth M, Quist M. Exercise and relaxation intervention for patients with advanced lung cancer: a qualitative feasibility study. Scand J Med Sci Sports. 2012;22(6):804–15.
• 23) Quist M, Rorth M, Langer S, Jones LW, Laursen JH, Pappot H, Christensen KB, Adamsen L. Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy: a pilot study. Lung Cancer. 2011;75(2):203–8.
• 24) Quist M, Adamsen L, Rorth K, Laursen JH, Christensen KB, Langer SW. The impact of multidimensional exercise intervention on physical and functional capacity, anxiety, and depression in patients with advancedstage lung cancer undergoing chemotherapy. Integr Cancer Ther. 2015;14(4):341–9.
• 25) Chen et al., Exercise Training for Improving Patient-Reported Outcomes in Patients With Advanced-Stage Cancer: A Systematic Review and Meta-Analysis. Journal of Pain and Symptom Management, 2020: (59);3.