Kifoskolyozisli Hastalarda Kapsamlı Pulmoner Rehabilitasyonun Etkinliği; Hangi Hastalarda Kazanımlar Belirgindir?

Amaç: Kifoskolyoz (KS) sık görülen bir spinal deformitedir. En sık görülen semptomlar nefes darlığı, azalmış egzersiz kapasitesi ve bozulmuş yaşam kalitesidir. Çalışmamızın amacı, KS’li hastalarda pulmoner rehabilitasyonun (PR) etkinliğini ve kazanımların hangi hastalarda belirgin olduğunu araştırmaktır. Gereç ve Yöntem: KS tanısı alan ve multidisipliner, kapsamlı, direkt gözetimli, ayaktan PR programını tamamlayan 46 hasta değerlendirildi. PR programı öncesi ve sonrasında solunum fonksiyonları, vücut kompozisyonu, egzersiz kapasitesi, solunum ve periferik kas kuvveti, yaşam kalitesi, psikolojik durumları değerlendirildi. Hastaların verileri geriye dönük olarak incelendi. Bulgular: PR programından sonra; Medical Research Council (MRC) seviyeleri, Borg, artan hızda mekik yürüme testi, dayanıklılık mekik yürüme testi, altı dakika yürüme testi, maksimum inspiratuvar basınç, maksimum ekspiratuvar basınç, el kavrama testi, deltoid ve kuadriseps 1-tekrar maksimum testleri, St. George Solunum Anketi (SGRQ), kronik solunum hastalıkları anketi, hastane anksiyete ve depresyon (HAD-anksiyete/depresyon) skorlarında istatistiksel olarak anlamlı farklılıklar gözlendi. Başlangıç FEV1 ile anksiyetedeki kazanım arasında istatistiksel olarak anlamlı bir negatif korelasyon vardı. Ayrıca başlangıçtaki MRC, SGRQ ve anksiyete değerleri ile depresyon düzeyi kazanımları arasında istatistiksel olarak anlamlı bir negatif korelasyon bulundu. Sonuç: Multidisipliner kapsamlı PR programından sonra dispne algısı, kas kuvvetleri, egzersiz kapasiteleri, yaşam kalitesi, anksiyete ve depresyon puanlarında iyileşme oldu. Sonuçlarımız, en belirgin kazanımların hastalığın erken evrelerinde olduğunu göstermektedir.

Efficacy of Comprehensive Pulmonary Rehabilitation in Patients with Kyphoscoliosis; in Which Patients, the Gainings are Prominent?

Objectives: Kyphoscoliosis (KS) is a common spinal deformity. The most common symptoms are dyspnea, reduced exercise capacity, and impaired quality of life. The aim of our study was to investigate the effectiveness of pulmonary rehabilitation (PR) in patients with KS and in which patients the gainings are prominent. Materials and Methods: Forty-six patients who were diagnosed as KS and completed a multidisciplinary comprehensive supervised outpatient PR program were evaluated. Pulmonary functions, body composition, exercise capacity, respiratory and peripheral muscle strength, quality of life, psychological states were assessed before and after the PR program. The data of the patients were reviewed retrospectively. Results: After the PR program, statistically significant differences were observed in Medical Research Council (MRC) levels, Borg, incremental shuttle walking test, endurance shuttle walking test, six minutes walk test, maximal inspiratory pressure, maximal expiratory pressure, hand grip test, deltoid and quadriceps 1-repetition maximum tests, St. George Respiratory Questionnaire (SGRQ), chronic respiratory diseases questionnaire, hospital anxiety and depression scores (HAD-anxiety/depression). There was a statistically significant negative correlation between the initial FEV1 and the gain in anxiety. We also found a statistically significant negative correlation between the initial MRC, SGRQ, anxiety values and the gainings in depression data. Conclusion: After multidisciplinary comprehensive PR program, there was an improvement in perception of dyspnea, muscle strengths, exercise capacities, quality of life, anxiety and depression scores. Our results indicate that the most prominent gainings were in the early stages of the disease.

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