The Effectiveness of Home-Based Pulmonary Rehabilitation in Elderly Patients with COVID-19 Infection

Yıl 2022, , 13 - 18, 14.01.2022

Mazlum Serdar Akaltun , Can Anıl , Özlem Altındağ , Neytullah Turan , Bahadır Demir , Savaş Gürsoy , Ali Gür

https://doi.org/10.20515/otd.943990

Öz

While Coronavirus disease-2019 (COVID-19) affects the whole world, most affected group is geriatric individuals. There is a need for strategies for geriatric individuals returning to society and their social life. The aim of this study is to investigate the effect of an 8-week home-based Pulmonary Rehabilitation program on quality of life, depression, anxiety and functional capacity in geriatric individuals with COVID-19. Twenty-five patients were included in this prospective study. Patients over 65 years of age with COVID-19 were evaluated. Physical capacity with the 6-minute walking test (6MWT), dyspnea status with the Medical Research Council Dyspnea Scale, quality of life with the Short Form-36 (SF-36), depression and anxiety with the Hospital Anxiety and Depression Scale were evaluated. The mean age of the patients included in the study was 68.9 ± 6.4 years. 56% of the patients were men and 44% were women. When pre-treatment and post-treatment values were compared, a significant improvement was found in the 6MWT, dyspnea scores, SF-36 and all subgroups, anxiety and depression scores (p <0.05). This study shows that the home-based Pulmonary Rehabilitation program is an effective method on parameters such as quality of life, depression and physical capacity in geriatric individuals with COVID-19. Prospective large-scale studies are needed to validate our current results.

Anahtar Kelimeler

Covid-19, pulmonary rehabilitation, quality of life

COVID-19 Geçirmiş Geriatrik Hastalarda Ev-Temelli Pulmoner Rehabilitasyonun Etkinliği

Öz

Coronavirüs hastalığı-2019 (COVID-19) tüm dünyayı etkilerken en çok etkilenen grup geriatrik bireylerdir. Geriatrik bireylerin topluma ve sosyal yaşamlarına dönmeleri için bazı stratejilere ihtiyaç vardır. Bu çalışmanın amacı, COVID-19'lu geriatrik bireylerde 8 haftalık ev temelli Pulmoner Rehabilitasyon programının yaşam kalitesi, depresyon, anksiyete ve fonksiyonel kapasite üzerine etkisini araştırmaktır. Bu prospektif çalışmaya 25 hasta dahil edildi. COVID-19 geçirmiş 65 yaş üstü hastalar değerlendirildi. Fiziksel kapasite 6 dakikalık yürüme testi (6DYT) ile, dispne durumlar Medical Research Council Dispne Skalası ile, yaşam kalitesi Kısa Form-36 (KF-36) ile, depresyon ve anksiyete durumları ise Hastane Anksiyete ve Depresyon Ölçeği ile değerlendirildi. Çalışmaya dahil edilen hastaların ortalama yaşı 68.9 ± 6.4 idi. Hastaların% 56'sı erkek,% 44'ü kadındı. Tedavi öncesi ve tedavi sonrası değerler karşılaştırıldığında 6DYT, dispne skorları, SF-36, anksiyete ve depresyon skorlarında anlamlı iyileşme saptandı (p <0.05). Bu çalışma, ev tabanlı Pulmoner Rehabilitasyon programının COVID-19'lu geriatrik bireylerde yaşam kalitesi, depresyon ve fiziksel kapasite gibi parametreler üzerinde etkili bir yöntem olduğunu göstermektedir. Mevcut sonuçlarımızı doğrulamak için ileriye dönük büyük örneklem büyüklüğüne sahip çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Covid-19, pulmoner rehabilitasyon, yaşam kalitesi

Kaynakça

• 1. Gao Y, Yan L, Huang Y, et al. Structure of the RNA-dependent RNA polymerase from COVID-19 virus. Science. 2020;368(6492):779-782.
• 2. Coronavirus Disease 2019 (COVID-19) Technical Guidance. Available at: https://www.who.int/health-topics/ coronavirus#tab=tab_1
• 3. Li JY, You Z, Wang Q, et al. The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future. Microbes Infect. 2020;22(2):80-85.
• 4. Jia N, Feng D, Fang LQ, et al. Case fatality of SARS in mainland China and associated risk factors. Trop Med Int Health. 2009;14 Suppl 1(Suppl 1):21-27.
• 5. Cao M, Zhang D, Wang Y, et al. Clinical Features of Patients Infected with the 2019 Novel Coronavirus (COVID-19) in Shanghai, China. Preprint. medRxiv. 2020;2020.03.04.20030395. Published 2020 Mar 6. doi:10.1101/2020.03.04.20030395
• 6. Garrod R, Lasserson T. Role of physiotherapy in the management of chronic lung diseases: an overview of systematic reviews. Respir Med. 2007;101(12):2429-2436.
• 7. Enright PL. The six-minute walk test. Respir Care. 2003;48(8):783-785.
• 8. Kim S, Oh J, Kim YI, et al. Differences in classification of COPD group using COPD assessment test (CAT) or modified Medical Research Council (mMRC) dyspnea scores: a cross-sectional analyses. BMC Pulm Med. 2013;13:35.
• 9. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-370.
• 10. Boueri FM, Bucher-Bartelson BL, Glenn KA, Make BJ. Quality of life measured with a generic instrument (Short Form-36) improves following pulmonary rehabilitation in patients with COPD. Chest. 2001;119(1):77-84.
• 11. Polastri M, Nava S, Clini E, Vitacca M, Gosselink R. COVID-19 and pulmonary rehabilitation: preparing for phase three. Eur Respir J. 2020;55(6):2001822.
• 12. Rodriguez-Morales AJ, Cardona-Ospina JA, Gutiérrez-Ocampo E, et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis. 2020;34:101623.
• 13. Liu K, Zhang W, Yang Y, Zhang J, Li Y, Chen Y. Respiratory rehabilitation in elderly patients with COVID-19: A randomized controlled study. Complement Ther Clin Pract. 2020;39:101166.
• 14. Pepin V, Saey D, Laviolette L, Maltais F. Exercise capacity in chronic obstructive pulmonary disease: mechanisms of limitation. COPD. 2007;4(3):195-204.
• 15. Kortebein P, Symons TB, Ferrando A, et al. Functional impact of 10 days of bed rest in healthy older adults. J Gerontol A Biol Sci Med Sci. 2008;63(10):1076-1081.
• 16. Reidy PT, McKenzie AI, Mahmassani Z, et al. Skeletal muscle ceramides and relationship with insulin sensitivity after 2 weeks of simulated sedentary behaviour and recovery in healthy older adults. J Physiol. 2018;596(21):5217-5236.
• 17. Khan S, Siddique R, Li H, et al. Impact of coronavirus outbreak on psychological health. J Glob Health. 2020;10(1):010331.
• 18. Deng, J., Zhou, F., Hou, W., et al. The prevalence of depression, anxiety, and sleep disturbances in COVID‐19 patients: a meta‐analysis. Annals of the New York Academy of Sciences. 2020.
• 19. Paz-Díaz H, Montes de Oca M, López JM, Celli BR. Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD. Am J Phys Med Rehabil. 2007;86(1):30-36.
• 20. von Leupoldt A, Taube K, Lehmann K, Fritzsche A, Magnussen H. The impact of anxiety and depression on outcomes of pulmonary rehabilitation in patients with COPD. Chest. 2011;140(3):730-736.
• 21. Brooks D, Sottana R, Bell B, et al. Characterization of pulmonary rehabilitation programs in Canada in 2005. Can Respir J. 2007;14(2):87-92.
• 22. Vieira DS, Maltais F, Bourbeau J. Home-based pulmonary rehabilitation in chronic obstructive pulmonary disease patients. Curr Opin Pulm Med. 2010;16(2):134-143.