Kronik obstrüktif akciğer hastalığında uyku kalitesi, fiziksel aktivite düzeyi ve fonksiyonel kapasite arasındaki ilişkinin değerlendirilmesi

Yıl 2025, Cilt: 4 Sayı: 2, 105 - 115, 29.08.2025

Yusuf Cerit , Arzu Demirgüç , Nevhiz Gündoğdu , Engin Ramazanoğlu

https://doi.org/10.63695/jhscr.1637967

Öz

Amaç: Bu çalışma, birleşik değerlendirme sistemine göre gruplandırılan hastaların fonksiyonel durumu ve yaşam kalitesi ile ilgili parametrelerini değerlendirmek amacıyla tasarlanmıştır.
Gereç ve Yöntemler: Çalışma, göğüs hastalıkları uzmanı tarafından tanı konulan ve göğüs hastalıkları polikliniğinde takip edilen 45 gönüllü kronik obstrüktif akciğer hastası ile tamamlanmıştır. Tüm hastalara solunum fonksiyon testi, KOAH değerlendirme testi, Modifiye Medikal Araştırma Konseyi Skalası, Pittsburgh Uyku Kalitesi İndeksi, Uluslararası Fiziksel Aktivite Anketi Kısa Formu, Altı Dakika Yürüme Testi, 30 Saniye Otur-Kalk Testi ve el kavrama kuvveti değerlendirmeleri uygulanmıştır.
Bulgular: Katılımcıların toplamda %68,9'u düşük uyku kalitesine sahipken, %84,4'ü düşük düzeyde fiziksel aktivite grubunda yer almaktaydı. Birleşik değerlendirme sistemine göre kronik obstrüktif akciğer hastası yüksek ve düşük risk grupları, Pittsburgh Uyku Kalitesi İndeksi alt ölçek puanları açısından benzerlik gösterdi (p>0.05). Gruplar arasında fiziksel aktivite ve fonksiyonel kapasite açısından istatistiksel olarak anlamlı farklılıklar gözlendi (p<0.05).
Sonuç: Kronik obstrüktif akciğer hastaları yetersiz uyku kalitesi ve azalmış fiziksel aktivite düzeyleri ile karşı karşıya kalma eğilimindedir. Fonksiyonel kapasitedeki düşüşler, artan semptomlarla başvuran bireylerde daha belirgin hale gelmektedir.

Anahtar Kelimeler

Kronik Obstrüktif Akciğer Hastalığı , Uyku Kalitesi , Fiziksel Aktivite , Fonksiyonel Kapasite

Evaluation of the relationship between sleep quality, physical activity level, and functional capacity in chronic obstructive pulmonary disease

Öz

Aim: This study was designed to evaluate the functional status and quality of life-related parameters of patients grouped according to the combined assessment system.
Material and Methods: The study was completed with 45 volunteer Chronic obstructive pulmonary disease by a chest diseases specialist and followed up in the chest diseases outpatient clinic. In all patients pulmonary function test, COPD assessment test, modified medical research council, pittsburg sleep quality ındex, ınternational physical activity questionnaire short form, six-minute walk test, 30 second sit to stand test and hand grip strength assesments were made.
Results: A total of 68.9% of the participants experienced low sleep quality and 84.4% were in the low level physical activity group. Based on the integrated evaluation system, Chronic obstructive pulmonary disease high and groups with lower risk showed similarity concerning pittsburg sleep quality ındex subscale scores (p>0.05). Statistically significant differences were observed among the groups in terms of physical activity and functional capacity (p<0.05).
Conclusion: Chronic obstructive pulmonary disease tend to experience inadequate sleep quality and reduced physical activity levels. Decreases in functional capacity are more pronounced in individuals presenting with increased symptoms.

Anahtar Kelimeler

Chronic Obstructive Pulmonary Disease , Sleep Quality , Physical Activity , Functional Capacity

Etik Beyan

Consent forms were obtained from patients who would voluntarily participate in the study. Permission was obtained from the SANKO University Non-Interventional Clinical Studies Ethics Committee with the decision number 2020/08 on 02.06.2020.

Teşekkür

The authors would like to thank all individuals who participated in this study.

Kaynakça

• Barnes PJ. Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol. 2016;138(1):16-27. https://doi.org/10.1016/j.jaci.2015.10.035
• Vogelmeier CF, Criner GJ, Martínez FJ, Anzueto A, Barnes PJ, Bourbeau J. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary. Arch Bronconeumol. 2017;53(3):128-49. https://doi.org/10.1016/j.arbres.2017.01.003
• Chang CH, Chuang LP, Lin SW, Lee CS, Tsai YH, Wei YF. Factors responsible for poor sleep quality in patients with chronic obstructive pulmonary disease. BMC Pulm Med. 2016;16(1):118. https://doi.org/10.1186/s12890-016-0253-3
• Çuhadaroğlu C. Kronik Obstrüktif Akciğer Hastalığı ve Uyku. Toraks Kitapları. 2008;6:269-75.
• Ding B, Small M, Bergström G, Holmgren U. A cross-sectional survey of night-time symptoms and impact of sleep disturbance on symptoms and health status in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:589-99. https://doi.org/10.2147/COPD.S127744
• Saaresranta T, Irjala K, Aittokallio T, Polo O. Sleep quality, daytime sleepiness and fasting insulin levels in women with chronic obstructive pulmonary disease. Respir Med. 2005;99(7):856-63. https://doi.org/10.1016/j.rmed.2004.10.003
• Soriano JB, Lamprecht B, Ramírez AS, Martinez-Camblor P, Kaiser B, Alfageme I. Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2007 and 2011 staging systems: a pooled analysis of individual patient data. Lancet Respir Med. 2015;3(6):443-50. https://doi.org/10.1016/S2213- 2600(15)00241-1
• Kim J, Yoon HI, Oh YM, Lim SY, Lee JH, Kim TH. Lung function decline rates according to GOLD group in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:1819-27. https://doi.org/10.2147/COPD.S88802
• Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988;93(3):580-86. https://doi.org/10.1378/chest.93.3.580
• Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34(3):648-54. https://doi.org/10.1183/09031936.00102509
• Yorgancıoğlu A, Polatlı M, Aydemir Ö, Yılmaz Demirci N, Kırkıl G, Naycı Atış S. KOAH değerlendirme testinin Türkçe geçerlilik ve güvenilirliği. Tuberk Toraks. 2012;60(4):314-20. https://doi.org/10.5578/tt.4321
• Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. https://doi.org/10.1016/0165-1781(89)90047-4
• Sağlam M, Arıkan H, Savcı S, İnal-İnce D, Bosnak-Guçlu M, Karabulut E. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010;111(1):278-84. https://doi.org/10.2466/pms.111.1.278-284
• American Thoracic Society. Guidelines for six-minute walk test. Am J Respir Crit Care Med. 2002;166:111-17. https://doi.org/10.1164/ajrccm.166.1.at110-02
• Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in communityresiding older adults. Res Q Exerc Sport. 1999;70(2):113-19. https://doi.org/10.1080/02701367.1999.10608060
• Massy-Westropp NM, Gill TK, Taylor AW, Bohannon RW, Hill CL. Hand grip strength: age and gender stratified normative data in a population-based study. BMC Res Notes. 2011;4:127. https://doi.org/10.1186/1756-0500-4-127
• Vardar-Yagli N, Sağlam M, Savcı S, İnal-İnce D, Çalık-Kütükçü E, Arıkan H. Impact of sleep quality on functional capacity, peripheral muscle strength and quality of life in patients with chronic obstructive pulmonary disease. Expert Rev Respir Med. 2015;9(2):233-39. https://doi.org/10.1586/17476348.2015.1011386
• Chen R, Tian JW, Zhou LQ, Chen X, Yan HY, Zeng B. The relationship between sleep quality and functional exercise capacity in COPD. Clin Respir J. 2016;10(4):477-85. https://doi.org/10.1111/crj.12270
• Domholdt E. Physical therapy research. Principles and applications. St. Louis: Saunders; 1993.
• Johannessen A, Nilsen RM, Storebø M, Gulsvik A, Eagan T, Bakke P. Comparison of 2011 and 2007 Global Initiative for Chronic Obstructive Lung Disease guidelines for predicting mortality and hospitalization. Am J Respir Crit Care Med. 2013;188(1):51-59. https://doi.org/10.1164/rccm.201301- 0081OC
• Öztürk Ö. Kronik Obstrüktif Akciğer Hastalığı ve Uyku. Solunum Dergisi. 2011;13:67-77.
• Omachi TA, Blanc PD, Claman DM, Chen H, Yelin EH, Julian L. Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes. Sleep Med. 2012;13(5):476-83. https://doi.org/10.1016/j.sleep.2011.09.013
• Valipour A, Lavie P, Lothaller H, Mikulic I, Burghuber OC. Sleep profile and symptoms of sleep disorders in patients with stable mild to moderate chronic obstructive pulmonary disease. Sleep Med. 2011;12(4):367-72. https://doi.org/10.1016/j.sleep.2011.03.009
• Spina G, Spruit MA, Alison J, Benzo RP, Calverley PMA, Clarenbach CF. Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity. Thorax. 2017;72(8):694-701. https://doi.org/10.1136/thoraxjnl-2016-209105
• Geiger-Brown J, Lindberg S, Krachman S, McEvoy CE, Criner GJ, Connett JE. Self-reported sleep quality and acute exacerbations of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:389-97. https://doi.org/10.2147/COPD.S75840
• Zeidler MR, Martin JL, Kleerup EC, Schneider H, Mitchell MN, Hansel NN. Sleep disruption as a predictor of quality of life among patients in the subpopulations and intermediate outcome measures in COPD study (SPIROMICS). Sleep. 2018;41(5). https://doi.org/10.1093/sleep/zsy025
• Demeyer H, Donaire-Gonzalez D, Gimeno-Santos E, Ramon MA, De Battle J, Benet M. Physical activity is associated with attenuated disease progression in chronic obstructive pulmonary disease. Med Sci Sports Exerc. 2019;51(5):833-40. https://doi.org/10.1249/MSS.0000000000001851
• Garcia Aymerich J. Physical activity and COPD development. Time to advocate. Thorax. 2019;74(9):831-32. https://doi.org/10.1136/thoraxjnl-2019-213593
• Mantoani LC, Hernandes NA, Guimarães MM, Vitorasso RL, Probst VS, Pitta F. Does the BODE index reflect the level of physical activity in daily life in patients with COPD? Rev Bras Fisioter. 2011;15(2):131- 37. https://doi.org/10.1590/S1413-35552011000200007
• Silva GP, Morano MT, Cavalcante AG, De Andrade NM, Daher Ede F, Pereira ED. Exercise capacity impairment in COPD patients with comorbidities. Rev Port Pneumol. 2006;21(5):233-38. https://doi.org/10.1016/S0873-2159(06)70116-7
• Barreiro E, Bustamante V, Cejudo P, Gáldiz JB, Gea J, de Lucas P. Guidelines for the evaluation and treatment of muscle dysfunction in patients with chronic obstructive pulmonary disease. Arch Bronconeumol. 2015;51(8):384-95. https://doi.org/10.1016/j.arbres.2015.02.005
• Iliaz S, Cagatay T, Bingol Z, Okumus G, Iliaz R, Kuran G. Does the 6-minute walk test predict nocturnal oxygen desaturation in patients with moderate to severe COPD? Chron Respir Dis. 2015;12(1):61-68. https://doi.org/10.1177/1479972314564024
• Silva BSA, Lira FS, Ramos D, Uzeloto JS, Rossi FE, Freire APCF. Severity of COPD and its relationship with IL-10. Cytokine. 2018;106:95-100. https://doi.org/10.1016/j.cyto.2018.02.022
• Vonbank K, Marzluf B, Knötig M, Funk GC. Agreement between Cardiopulmonary Exercise Test and Modified 6-Min Walk Test in Determining Oxygen Uptake in COPD Patients with Different Severity Stages. Respiration. 2020;99(3):225-30. https://doi.org/10.1159/000505702
• Singer JP, Katz PP, Iribarren C, Omachi TA, Sanchez G, Yelin EH. Both pulmonary and extra-pulmonary factors predict the development of disability in chronic obstructive pulmonary disease. Respiration. 2013;85(5):375-83. https://doi.org/10.1159/000350906
• Shrikrishna D, Patel M, Tanner RJ. Quadriceps wasting and physical inactivity in patients with COPD. Eur Respir J. 2012;40(5):1115-22. https://doi.org/10.1183/09031936.00006512
• Vogiatzis I, Terzis G, Stratakos G, Cherouveim E, Athanasopoulos D, Spetsioti S. Effect of pulmonary rehabilitation on peripheral muscle fiber remodeling in patients with COPD in GOLD stages II to IV. Chest. 2011;140(3):744-52. https://doi.org/10.1378/chest.10-3221
• Validya T, Chambellan A, de Bisschop C. Sit-to-stand tests for COPD: A literature review. Respir Med. 2017;128:70-77. https://doi.org/10.1016/j.rmed.2017.07.003
• Ozalevli S, Ozden A, Itil O, Akkoclu A. Comparison of the Sit-to-Stand Test with 6 min walk test in patients with chronic obstructive pulmonary disease. Respir Med. 2007;101(2):286-93. https://doi.org/10.1016/j.rmed.2006.06.013
• R, Troosters T, Decramer M. Distribution of muscle weakness in patients with stable chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2000;20(6):353-60. https://doi.org/10.1097/00008483- 200011000-00002
• Felipe C, Bartolome C, Miguel D, Victor PP. Longitudinal changes in handgrip strength, hyperinflation, and 6-minute walk distance in patients with COPD and a control group. Chest. 2015;148(4):986-94. https://doi.org/10.1378/chest.15-0121
• Calik-Kutukcu E, Arikan H, Saglam M, Vardar-Yagli N, Oksuz C, Inal-Ince D. Arm strength training improves activities of daily living and occupational performance in patients with COPD. Clin Respir J. 2017;11(6):820-32. https://doi.org/10.1111/crj.12412
• Strandkvist V, Andersson M, Backman H, Larsson A, Stridsman C, Lindberg A. Hand grip strength is associated with fatigue among men with COPD: epidemiological data from northern Sweden. Physiother Theory Pract. 2020;36(3):408-16. https://doi.org/10.1080/09593985.2019.1637463