Sevgi ÖZALEVLI, Gamze YALÇINKAYA, Aylin Özgen APAYDIN

Pulmoner rehabilitasyonun erişkin kistik fibrozisli hasta üzerindeki etkisi: bir olgu sunumu

Kistik fibrozis otozomal resesif geçişli, hastaların solunum fonksiyonları ve günlük yaşam aktivitelerini etkileyen ölümcül bir hastalıktır. Kistik fibrozisli popülasyonun %50’si 18 yaş ve üzeri erişkin hastalardan oluşmaktadır. Erişkin kistik fibroziste en yaygın görülen problemler solunum fonksiyonları ve egzersiz kapasitesinin azalmasıdır. Ek olarak, sistematik etkilenimden dolayı diyabet, osteoporoz ve ağrı gibi birçok farklı problem de görülebilmektedir. Erişkin kistik fibrozisli hastalarda pulmoner rehabilitasyonun mukus klirensini ve egzersiz toleransını artırdığı bilinmektedir ancak bu popülasyonda pulmoner rehabilitasyonun etkinliğini araştıran yayınlar sınırlı sayıdadır. Bu nedenle, çalışmamızda kistik fibrozisli erişkin bir hastanın pulmoner rehabilitasyon programı gerçekleştirildi. Hasta, haftada iki seans olacak şekilde 8 haftalık hastaya özgü planlanmış bir pulmoner rehabilitasyon programına dahil edildi. Programının öncesinde ve sonrasında hastanın dispne seviyesi, solunum fonksiyon testi, kardiyopulmoner egzersiz testi, gövde kaslarının statik stabilizasyonu, quadriceps kas kuvveti, kavrama kuvveti ve sağlıkla ilişkili yaşam kalitesi değerlendirildi. Pulmoner rehabilitasyon programı kapsamında hastamıza solunum egzersizleri, bronşiyal hijyen teknikleri, aerobik eğitim ve ev programı uygulandı. 8 haftalık pulmoner rehabilitasyon programı sonunda hastanın 6 dakika yürüme mesafesi, kardiyopulmoner egzersiz testi parametreleri ve solunum fonksiyon test sonuçları artarken, algılanan dispne şiddeti azaldı. Hastanın quadriceps kas kuvvetinde tedavi başlangıcına göre değişim görülmezken, kavrama kuvveti ve statik gövde enduransı arttı. Ek olarak, Saint George Solunum Anketi’ne göre hastanın yaşam kalitesinin arttığı belirlendi.

Anahtar Kelimeler:

Kistik fibrozis, pulmoner rehabilitasyon, egzersiz

Effect of pulmonary rehabilitation on adult cystic fibrosis patient: a case report

Cystic fibrosis is an autosomal recessive and fatal disease that affect the respiratory functions and daily living activities of patients. Fifty percent of the cystic fibrosis population consists of adult patients aged 18 years and older. The most common problems are decreased pulmonary function and exercise capacity in adult cystic fibrosis. In addition, many different comorbidities can be seen such as diabetes, osteoporosis and pain due to systematic influence. Pulmonary rehabilitation is known to increase mucus clearance and exercise tolerance in adult cystic fibrosis patients, however the studies that investigating the effectiveness of pulmonary rehabilitation are limited in this population. Therefore, pulmonary rehabilitation program of an adult patient with cystic fibrosis was performed in our study. The patient was included in an 8-week supervised pulmonary rehabilitation program with two sessions per week. The patient's severity of dyspnea perception, pulmonary function test, cardiopulmonary exercise test, static stabilization of the trunk muscles, quadriceps muscle strength, grip strength and health-related quality of life were assessed before and after the pulmonary rehabilitation program. Breathing exercises, bronchial hygiene techniques, aerobic training and home program were applied to our patient within the scope of pulmonary rehabilitation program. The patient's severity of dyspnea perception was decreased while 6-minute walking distance, cardiopulmonary exercise test parameters and respiratory function test results increased at the end of the 8-week supervised pulmonary rehabilitation program. The patient’s grip strength and static trunk endurance increased while the quadriceps muscle strength did not change. In addition, it was determined that the patient’s quality of life increased according to the Saint George Respiratory Questionnaire.

Keywords:

Cystic fibrosis, Pulmonary Rehabiltation, Exercise,

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