PULMONER REHABİLİTASYONDA EGZERSİZ EĞİTİMİ

Pulmoner rehabilitasyon (PR); klinik ve/veya fizyolojik olarak saptanmış kronik respiratuar hastalığa bağlı yetersizlik veya özürlülüğü olan bireyin, kişisel günlük fonksiyonlarını ve sağlıkla ilgili yaşam kalitesini optimal olarak sürdürebilmesi için bilimsel bazlı tanı ve tedavi seçeneğini kullanan bir yöntem olarak tanımlanmıştır. Egzersiz toleransinda düşüklük KOAH hastalarında sık görülen bir problemdir. Egzersiz intoleransının nedeni multifaktöriyel ve bunlar: akciğer ve solunum kaslarının bozukluğu; kardiyak disfonksiyon; gaz değişiminde değişme; kötü beslenme durumu; dekondüsyonu; değişen derecelerde psikolojik sorunlardır . Günümüzde, egzersiz eğitimi pulmoner rehabilitasyon önemli bir bileşenidir, ancak egzersiz eğitiminde en iyi metodun ne olduğu hakkında bir konsensus yoktur.

Training Exercise on Pulmonary Rehabilitation

Aim: Pulmonary rehabilitation is a process which systematically uses scientifically based diagnostic management and evaluation options to achieve the optimal daily functioning and health-related quality of life of individual patients suffering from impairment and disability due to chronic respiratory disease, as measured by clinically and/or physiologically relevant outcome measures. Impairment of exercise tolerance is a common problem in patients with COPD. The cause of exercise intolerance is multifactorial and these; impairment of lung mechanics and respiratory muscles; cardiac dysfunction; altered gas exchange; poor nutritional status; deconditioning; and psychological problems of varying degrees. At present, exercise training is an important component of pulmonary rehabilitation, but no consensus exists as to the best methods of exercise.

PDF

___

Köseoğlu Fusun Pulmoner rehabilitasyon. Beyazova M, kutsal YG (Eds) Fiziksel tıp ve rehabilitasyon. Güneş Kitap Evi s.1565-1577
Donner CF, Muir JF. Selection criteria and programmes for pulmonary rehabilitation in COPD patients: ERS Tesk Force Position Paper. Eur Respir J 1997: 10: 744-57.
Nici L, Donner C, Wouters E ve ark. American Thorasic Society / European Respiratory Society Statement on Pulmonary Rehabilitation. Am J Respir Crit Care Med ;173:1390-1413.
O'Donnell DE, Revill SM, Webb KA. Dynamic hyperinfl ation and exercise intolerance in chronic obstructive pulmonary disease. Am J Respir Crit Care Med ;164:770-7.
Trooster T, Donner CF, Schols AMWJ, Decramer M. Rehabilitation in chronic obstructive pulmonary disease. Eur Respir Mon 2006;38:337-58.
Mc Ardle WD, Katch FI, Katch L. Exercise physiology Energy, nutrition, and Human Performance. Fifth Ed. Baltimore, Maryland. Wiliamsand Wilkins. 2001;458-99
Ries AL, Bauldoff GS, Carlin BW, et al. Pulmonary Rehabilitation: Joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest 2007;131:4-42.
Kraemer WJ, Adams S Cafarelli E ve ark American College of Sports Medicine position stand . Progression models in resistance training for healthy adults. Med Sci Sports Exerc ;34:364
Mc Ardle WD, Katch FI, Katch L. Exercise physiology Energy, nutrition, and Human Performance. Fifth Ed. Baltimore, Maryland. Wiliamsand Wilkins. 2001;458-99.
Sipila S, Souminen H. Effects of strength and endurance training on thigh and leg muscle mass and composition in elderly women. J Appl Physiol 1995; 78:334-40.
Ries AL. The importance of exercise in pulmonary rehabiliion. Clin Chest Med 1994;15:327-36
Troosters T, Casaburi R, Gosselink R, Decramer M. Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2005;172:19-38.
Gosseling R,Decramer M. Muscle training in pulmonary rehabilitation.In Donner CF, Decramer M (Eds):pulmonary rehabilitation. ERS journals Ltd, UK, 2000.s.99-111
Puhan MA, Schünemann HJ, Frey M, Bachmann LM Value of suslemental interventions to enhance the effectiveness of physical exercise during respiratory rehabilitation in COPD patients. A Systematic Review. Respirator 2004;5:25.