2020, 8(1): 157-161 KOAH Tanılı Yaşlı Bireylerde Pulmoner Rehabilitasyon

Kronik obstrüktif akciğer hastalığı (KOAH) yüksek morbidite ve mortalite oranları olan, yaşlı popülasyonda yaygın olarak görülen ve prevalansı yaşla birlikte artan kronik respiratuar bir problemdir. Yaşlı nüfus oranının dünya genelinde artmasıyla birlikte KOAH özellikle gelişmiş ülkelerde majör bir halk sağlığı problemi olmuştur ve en yüksek mortalite nedenleri arasında yer almaktadır. Yaşa bağlı olarak akciğerlerde meydana gelen fizyolojik değişiklikler ve çevresel faktörler nedeniyle KOAH prevalansı yaşlılarda yüksektir. Pulmoner rehabilitasyon ve inhaler farmakolojik ajanlar, KOAH'lı yaşlıların bireysel tedavisinde önemli bir yere sahiptir. Pulmoner rehabilitasyon yaşlılarda fonksiyonel egzersiz kapasitesinin ve sağlıkla ilgili yaşam kalitesinin geliştirilmesinde; dispnenin, sağlık hizmetlerinin kullanımı ve sağlık maliyetlerinin azaltılmasında etkindir. Yapılan çalışmalar KOAH'lı yaşlı bireylerin, pulmoner rehabilitasyondan genç hastalar kadar fayda görmekte olduğunu, dolayısıyla yaşın pulmoner rehabilitasyon için bir dışlama kriteri olmadığını göstermektedir. Hastalığın akut alevlenme dönemlerinde bile yaşlılarda pulmoner rehabilitasyonun etkin olduğu görülmüştür. Bu derlemede KOAH tanısı olan yaşlı bireylerde pulmoner rehabilitasyonun bileşenleri olan aerobik ve dirençli egzersizler, respiratuar kas kuvvet eğitimi, diafragmatik solunum ve fiziksel aktivitenin etkinliği güncel literatür ışığında tartışılacaktır.

Pulmonary Rehabilitation in Elderly Individuals with COPD

Chronic obstructive pulmonary disease (COPD) is a chronic respiratory problem with high morbidity and mortality rates and common in the elderly population with increasing prevalence by aging. COPD is among the highest causes of mortality and has been a major public health problem, especially in developed countries, as the elderly population increases worldwide. The prevalence of COPD is high in the elderly due to age-related physiological changes in the lungs and environmental factors. Pulmonary rehabilitation and inhaler pharmacological agents play an important role in the individual treatment of the elderly with COPD. Pulmonary rehabilitation is effective in improving functional exercise capacity and health-related quality of life; reducing dyspnea, the use of health services and health costs in the elderly. Studies have shown that elderly individuals with COPD benefit from pulmonary rehabilitation as much as younger patients, and therefore age is not an exclusion criterion for pulmonary rehabilitation. Even in acute exacerbations, pulmonary rehabilitation is effective in the elderly. In this review; aerobic and resistant exercises, respiratory muscle strength training, diaphragmatic respiration and physical activity, the components of pulmonary rehabilitation in elderly individuals with COPD, will be discussed in the light of the current literature.

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